Organization
REVIVE COUNSELING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DENISE MCCOLLIN-TWYMAN LCSW-C (EMPLOYEE)
(301) 787-2049
Entity
Organization
Contact information
Practice address
8701 TRYAL CT, MONTGOMERY VILLAGE, MD 20886-4362
(301) 787-2049
Mailing address
8701 TRYAL CT, MONTGOMERY VILLAGE, MD 20886-4362
(301) 787-2049
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
01/18/2022
Last updated
01/25/2022
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