Organization
REVITALIZE PSYCHIATRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASEY WATSON PMHNP (OWNER)
(704) 459-2181
Entity
Organization
Contact information
Practice address
11220 ELM LN STE 203-9, CHARLOTTE, NC 28277-0715
(704) 459-2181
(704) 533-9516
Mailing address
8022 PROVIDENCE RD STE 500-229, CHARLOTTE, NC 28277-9719
(704) 459-2181
(704) 533-9516
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/13/2023
Last updated
04/02/2023
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