MENTAL HEALTH PRO PA REVIVED WELLNESS
NPI 1366310112
Nurse Practitioner - Psychiatric/Mental Health in San Antonio, TX

Q: What is Mental Health Pro PA Revived Wellness's specialty?

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

Active since October 24, 2025

4400 S PIEDRAS DR STE 217, SAN ANTONIO, TX 78228(210) 903-3383 Get Directions Write a Review

NPPES record last updated: March 5, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Mental Health Pro Pa Revived Wellness NPPES

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

MENTAL HEALTH PRO PA REVIVED WELLNESS (NPI 1366310112) is a healthcare organization registered as a psychiatric/mental health in San Antonio, Texas and active in the NPI registry since October 2025. The organization lists Victoria Eneyi Abolarin, Owner Of Entity, as its authorized official.

NPPES Registry Identity

NPI1366310112

Entity TypeOrganization

Primary Taxonomy363LP0808X

Legal Business NameMENTAL HEALTH PRO PA REVIVED WELLNESS

Location Address4400 S PIEDRAS DR STE 217San Antonio, TX 78228-1223

Mailing Address7475 Callaghan RdSan Antonio, TX 78229-2969 · (210) 903-3383 · Fax (210) 544-5194

Phone(210) 903-3383

Organization SubpartNo

Authorized OfficialVictoria Eneyi AbolarinOwner Of Entity · (818) 300-9424

Enumeration DateOctober 24, 2025

Last NPPES UpdateMarch 5, 2026

NPPES CertifiedMarch 5, 2026

✔ NPI 1366310112 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

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

Taxonomy Code363LP0808X

4400 S PIEDRAS DR STE 217, San Antonio, TX 78228

Open in Google Maps ↗

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

Other Providers at the Same Location NPPES 3

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

SA HEALTH AND WELLNESS LLC

Nurse Practitioner (Family)

4400 S PIEDRAS DR STE 217
SAN ANTONIO, TX 78228

Bexar County (210) 275-1375

GRACE & KRISTOPHER RICHARDSON PLLC

Psychiatry & Neurology (Psychiatry)

4400 S PIEDRAS DR STE 217
SAN ANTONIO, TX 78228

Bexar County (210) 831-6968

KRISTOPHER L. RICHARDSON, PA-C, PLLC

Psychiatry & Neurology (Psychiatry)

4400 S PIEDRAS DR STE 217
SAN ANTONIO, TX 78228

Bexar County (210) 831-6968

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mental Health Pro PA Revived Wellness's NPI number?

The NPI number for Mental Health Pro PA Revived Wellness is 1366310112. It was assigned to this organization in the NPPES registry on October 24, 2025.

Where is Mental Health Pro PA Revived Wellness located?

Mental Health Pro PA Revived Wellness is located at 4400 S Piedras Dr Ste 217, San Antonio, TX 78228. The listed phone number is (210) 903-3383.

What is Mental Health Pro PA Revived Wellness's specialty?

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

When was this NPI record last updated?

The NPPES record for Mental Health Pro PA Revived Wellness was last updated on March 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.