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Organization
REVIVAL WELLNESS GROUP LLC
Active
Organization
REVIVAL WELLNESS GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAYLEE DURNELL LCSW (OWNER)
(814) 282-5489
Entity
Organization
Contact information
Practice address
11216 FALL CREEK RD STE 102, INDIANAPOLIS, IN 46256-9406
(814) 282-5489
Mailing address
7264 S WOODROW DR, PENDLETON, IN 46064-9102
(814) 282-5489
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/25/2026
Last updated
09/03/2026
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