Organization
CHILDRENS GRIEF CENTER OF EL PASO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN LEIGH REVTYAK LCSW-S (EXECUTIVE DIRECTOR)
(915) 525-9482
Entity
Organization
Contact information
Practice address
2616 MONTANA AVE, EL PASO, TX 79903-3712
(915) 532-6004
Mailing address
2616 MONTANA AVE, EL PASO, TX 79903-3712
(915) 532-6004
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
02/19/2025
Last updated
05/15/2026
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