Organization
REVIVE COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA BUETTNER LPC (OWNER)
(314) 365-6421
Entity
Organization
Contact information
Practice address
9666 OLIVE BLVD STE 510, SAINT LOUIS, MO 63132-3026
(314) 365-6421
Mailing address
5830 LOOKOUT VW, CEDAR HILL, MO 63016-1916
(314) 365-6421
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/27/2024
Last updated
12/23/2024
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