REVIVE & THRIVE MENTAL HEALTH, LLC
NPI 1356003628
Nurse Practitioner - Psychiatric/Mental Health in Wichita, KS

Q: What is Revive & Thrive Mental Health, LLC's NPI number?

The NPI number for Revive & Thrive Mental Health, LLC is 1356003628. It was assigned to this organization in the NPPES registry on October 13, 2021.

Q: What is Revive & Thrive Mental Health, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Active since October 13, 2021

4013 N RIDGE RD STE 110, WICHITA, KS 67205(316) 631-2454(316) 247-6062 Get Directions Write a Review

NPPES record last updated: July 7, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 7, 2024, May 10, 2023, Mar 7, 2023 and 1 more (4 updates tracked since 2021).

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About Revive & Thrive Mental Health, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

REVIVE & THRIVE MENTAL HEALTH, LLC (NPI 1356003628) is a healthcare organization registered as a psychiatric/mental health in Wichita, Kansas and active in the NPI registry since October 2021. The organization lists Evangeline Newsom, Owner, as its authorized official.

NPPES Registry Identity

NPI1356003628

Entity TypeOrganization

Primary Taxonomy363LP0808X

Legal Business NameREVIVE & THRIVE MENTAL HEALTH, LLC

Location Address4013 N RIDGE RD STE 110Wichita, KS 67205-8859

Mailing Address4013 N Ridge Rd Ste 110Wichita, KS 67205-8859 · (316) 201-6294 · Fax (316) 364-3020

Phone(316) 631-2454

Fax(316) 247-6062

Organization SubpartNo

Authorized OfficialEvangeline NewsomOwner · (316) 201-6294

Enumeration DateOctober 13, 2021

Last NPPES UpdateJuly 7, 20244 updates tracked since enumeration

NPPES CertifiedJuly 7, 2024

✔ NPI 1356003628 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 15

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X

Also ListedCounselor · ProfessionalTaxonomy 101YP2500X

Also ListedPsychologistTaxonomy 103T00000X

Also ListedPsychologist · Cognitive & BehavioralTaxonomy 103TB0200X

Also ListedPsychologist · ClinicalTaxonomy 103TC0700X

Also ListedPsychologist · CounselingTaxonomy 103TC1900X

Also ListedPsychologist · Clinical Child & AdolescentTaxonomy 103TC2200X

Also ListedSocial WorkerTaxonomy 104100000X

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X

Also ListedMarriage & Family TherapistTaxonomy 106H00000X

Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X

Also ListedClinic/Center · Adult Mental HealthTaxonomy 261QM0850X

Also ListedClinic/Center · Adolescent and Children Mental HealthTaxonomy 261QM0855X

4013 N RIDGE RD STE 110, Wichita, KS 67205

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Other Identifiers 3

Medicaid30004830030002KS

Other363LP0808XKS · Taxonomy

Medicaid30004842030001KS

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Kansas, Inc..Insurance ›

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BIANCA C RODRIGUEZ LMFT

Marriage & Family Therapist