Organization
REVIVE AND THRIVE COUNSELING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE DIAZ LPC (OWNER)
(703) 829-6554
Entity
Organization
Contact information
Practice address
11710 PLAZA AMERICA DR STE 2000, RESTON, VA 20190-4743
(703) 829-6554
Mailing address
8500 LAKINHURST LN, SPRINGFIELD, VA 22152-1727
(703) 829-6554
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
07/28/2025
Last updated
07/28/2025
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