# REVIVE COUNSELING & WELLNESS, LLC

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

## Provider details

- **NPI number:** 1891556288
- **Authorized official:** MRS. GAIL BIBB LCSW, LMFT (CEO, PSYCHOTHERAPIST)
- **Authorized official phone:** (502) 632-3282

## Contact information

- **Practice address:** 308 EVERGREEN RD STE 140, LOUISVILLE, KY 40243-1076
- **Practice address phone:** (502) 632-3282
- **Mailing address:** 308 EVERGREEN RD STE 140, LOUISVILLE, KY 40243-1076
- **Mailing address phone:** (502) 632-3282

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 01/22/2024
- **Last updated:** 01/22/2024