Organization
REVIRESCO COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LYNN WENDELL LPC-MHSP (OWNER)
(615) 538-5830
Entity
Organization
Contact information
Practice address
104 EAST PARK DRIVE, BUILDING 300, BRENTWOOD, TN 37027
(615) 538-5830
(949) 404-6194
Mailing address
104 EAST PARK DRIVE, BUILDING 300, BRENTWOOD, TN 37027
(615) 538-5830
(949) 404-6194
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1972003036
REVIRESCO COUNSELING, LLC
TN
Enumeration date
10/20/2022
Last updated
10/20/2022
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