Organization
REVIVE THERAPEUTIC COUNSELING SERVICES
Active
Parent organization
REVIVE THERAPEUTIC COUNSELING SERVICES
Other names
Revive Wellness, Revive Wellness Inc, Revive Behavioral Health Solutions
Organization subpart
Yes
Provider details
NPI number
Legal business name
REVIVE THERAPEUTIC COUNSELING SERVICES
Authorized official
CAMILLE A LEWIS (CLINICAL DIRECTOR)
(301) 276-1151
Entity
Organization
Contact information
Practice address
2255 CRAIN HWY STE 105, WALDORF, MD 20601-3186
(301) 276-1151
(301) 923-1329
Mailing address
2255 CRAIN HWY STE 105, WALDORF, MD 20601-3186
(301) 276-1151
(301) 923-1329
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
999013500
—
MD
Enumeration date
08/04/2022
Last updated
02/22/2026
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