# REVIVE COUNSELING SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689498412
- **Authorized official:** TINA MARIE KARRLE CSWA (CLINICIAN)
- **Authorized official phone:** (541) 205-9226

## Contact information

- **Practice address:** 3704 LA MARADA WAY, KLAMATH FALLS, OR 97603-7632
- **Practice address phone:** (541) 205-9226
- **Mailing address:** 3704 LA MARADA WAY, KLAMATH FALLS, OR 97603-7632
- **Mailing address phone:** (541) 205-9226

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 11/08/2024
- **Last updated:** 01/17/2025