REVOLUTIONARY WELLNESS, PLLC - NPI 1609311455 - Clinic/Center in Georgetown, TX

Q: What is the provider's specialty?

The provider's specialty is Clinic/Center with taxonomy code 261QM0855X and a focus in Adolescent and Children Mental Health.

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About Revolutionary Wellness, Pllc NPPES

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

REVOLUTIONARY WELLNESS, PLLC (NPI 1609311455) is a healthcare organization registered as an adolescent and children mental health in Georgetown, Texas and active in the NPI registry since January 2017. The organization lists Lisa A Margraves, Managing Partner, as its authorized official.

NPPES Registry Identity

NPI1609311455

Entity TypeOrganization

Primary Taxonomy261QM0855X

Legal Business NameREVOLUTIONARY WELLNESS, PLLC

Location Address213 SINUSO DRGeorgetown, TX 78628-1533

Mailing Address213 Sinuso DrGeorgetown, TX 78628-1533 · (512) 569-4017

Phone(512) 569-4017

Organization SubpartNo

Authorized OfficialLisa A MargravesManaging Partner · (512) 569-4017

Enumeration DateJanuary 4, 2017

Last NPPES UpdateNovember 10, 20253 updates tracked since enumeration

NPPES CertifiedNovember 10, 2025

✔ NPI 1609311455 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ Primary SpecialtyClinic/Center · Adolescent and Children Mental HealthAmbulatory Health Care Facilities

Taxonomy Code261QM0855X

Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.

Also ListedCounselor · ProfessionalTaxonomy 101YP2500X

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X

Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X

Also ListedClinic/Center · Mental Health (Including Community Mental Health Center)Taxonomy 261QM0801X

Also ListedClinic/Center · Adult Mental HealthTaxonomy 261QM0850X

213 SINUSO DR, Georgetown, TX 78628

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