| Revitalize Counseling & Consultation Services | |
|
610 Isaac Hayes Dr. Dyersburg TN 38024 | |
| (901) 569-2823 | |
| Not Available |
| Full Name | Revitalize Counseling & Consultation Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 610 Isaac Hayes Dr., Dyersburg, Tennessee |
| Authorized Official Name and Position | Steven Foster Murphy (PRESIDENT) |
| Authorized Official Contact | 9015692823 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Revitalize Counseling & Consultation Services 610 Isaac Hayes Dr Dyersburg TN 38024-3668 Ph: (901) 569-2823 | Revitalize Counseling & Consultation Services 610 Isaac Hayes Dr. Dyersburg TN 38024 Ph: (901) 569-2823 |
| NPI Number | 1053195263 |
|---|---|
| Provider Enumeration Date | 08/21/2023 |
| Last Update Date | 03/28/2024 |
| Certification Date | 03/28/2024 |
| Medicare PECOS PAC ID | 6608217344 |
|---|---|
| Medicare Enrollment ID | O20240513003493 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053195263 | NPI | - | NPPES |
| Provider Name | Steven F Murphy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861270985 PECOS PAC ID: 7416398151 Enrollment ID: I20240513003528 |
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