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REVIVAL COLLABORATIVE LLC
NPI 1407515620
Counselor - Mental Health in Bentonville, AR

Active since December 15, 2021
3700 MEDICAL CENTER PKWY, BENTONVILLE, AR 72712(479) 721-2110 Get Directions Write a Review

NPPES record last updated: December 15, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Revival Collaborative Llc NPPES

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

REVIVAL COLLABORATIVE LLC (NPI 1407515620) is a healthcare organization registered as a mental health in Bentonville, Arkansas and active in the NPI registry since December 2021. The organization lists Zach S Hedges, Owner, as its authorized official.

NPPES Registry Identity

NPI1407515620
Entity TypeOrganization
Primary Taxonomy101YM0800X
Legal Business NameREVIVAL COLLABORATIVE LLC
Location Address3700 MEDICAL CENTER PKWYBentonville, AR 72712-3222
Mailing Address3202 Sw Hazelnut AveBentonville, AR 72713-3195 · (479) 721-2110
Phone(479) 721-2110
Organization SubpartNo
Authorized OfficialZach S HedgesOwner · (479) 721-2110
Enumeration DateDecember 15, 2021
NPPES CertifiedDecember 15, 2021
✔ NPI 1407515620 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
3700 MEDICAL CENTER PKWY, Bentonville, AR 72712
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

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

JENNIFER CONYAC
Counselor (Mental Health)
3700 MEDICAL CENTER PKWY
BENTONVILLE, AR 72712
Benton County (918) 800-1574
MR. ZACHARY S HEDGES LPC
Counselor (Professional)
3700 MEDICAL CENTER PKWY
BENTONVILLE, AR 72712
Benton County (479) 721-2110

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 Revival Collaborative LLC's NPI number?

The NPI number for Revival Collaborative LLC is 1407515620. It was assigned to this organization in the NPPES registry on December 15, 2021.

Where is Revival Collaborative LLC located?

Revival Collaborative LLC is located at 3700 Medical Center Pkwy, Bentonville, AR 72712. The listed phone number is (479) 721-2110.

What is Revival Collaborative LLC's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Revival Collaborative LLC was last updated on December 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.