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REVIVE COUNSELING AND COACHING LLC
NPI 1437871845
Social Worker - Clinical in Niceville, FL

Active since September 13, 2022
1016 JOHN SIMS PKWY E STE B, NICEVILLE, FL 32578(989) 715-4404 Get Directions Write a Review

NPPES record last updated: September 13, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Revive Counseling And Coaching Llc NPPES

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

REVIVE COUNSELING AND COACHING LLC (NPI 1437871845) is a healthcare organization registered as a clinical in Niceville, Florida and active in the NPI registry since September 2022. The organization lists Ruby Lisa Hawkins-jack, Licensed Clinical Social Worker, as its authorized official.

NPPES Registry Identity

NPI1437871845
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameREVIVE COUNSELING AND COACHING LLC
Location Address1016 JOHN SIMS PKWY E STE BNiceville, FL 32578-2202
Mailing Address224 Hillside DrNiceville, FL 32578-2354
Phone(989) 715-4404
Organization SubpartNo
Authorized OfficialRuby Lisa Hawkins-jackLicensed Clinical Social Worker · (989) 715-4404
Enumeration DateSeptember 13, 2022
NPPES CertifiedSeptember 13, 2022
✔ NPI 1437871845 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
1016 JOHN SIMS PKWY E STE B, Niceville, FL 32578
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Other Identifiers 1

Other1619233566Individual Npi

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Revive Counseling And Coaching Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Revive Counseling And Coaching LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Ruby Hawkins-Jack, LCSW
Clinical Social Worker
NPI 1619233566
358 JAMAICA WAY
Niceville, FL 32578
(850) 279-3045
✔ PECOS✔ Accepts Medicare3.5 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Revive Counseling And Coaching LLC's NPI number?

The NPI number for Revive Counseling And Coaching LLC is 1437871845. It was assigned to this organization in the NPPES registry on September 13, 2022.

Where is Revive Counseling And Coaching LLC located?

Revive Counseling And Coaching LLC is located at 1016 John Sims Pkwy E Ste B, Niceville, FL 32578. The listed phone number is (989) 715-4404.

What is Revive Counseling And Coaching LLC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Revive Counseling And Coaching LLC enrolled in Medicare?

Yes. Revive Counseling And Coaching LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Revive Counseling And Coaching LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Revive Counseling And Coaching LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Revive Counseling And Coaching LLC was last updated on September 13, 2022. 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.