| Revive & Thrive Mental Health, Llc | |
|
4013 N Ridge Rd Ste 110 Wichita KS 67205-8859 | |
| (316) 631-2454 | |
| (316) 247-6062 |
| Full Name | Revive & Thrive Mental Health, Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 4013 N Ridge Rd Ste 110, Wichita, Kansas |
| Authorized Official Name and Position | Evangeline Newsom (OWNER) |
| Authorized Official Contact | 3162016294 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Revive & Thrive Mental Health, Llc 4013 N Ridge Rd Ste 110 Wichita KS 67205-8859 Ph: (316) 201-6294 | Revive & Thrive Mental Health, Llc 4013 N Ridge Rd Ste 110 Wichita KS 67205-8859 Ph: (316) 631-2454 |
| NPI Number | 1356003628 |
|---|---|
| Provider Enumeration Date | 10/13/2021 |
| Last Update Date | 07/07/2024 |
| Certification Date | 07/07/2024 |
| Medicare PECOS PAC ID | 8224414750 |
|---|---|
| Medicare Enrollment ID | O20221006000223 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356003628 | NPI | - | NPPES |
| 30004830030002 | Medicaid | KS | |
| 363LP0808X | Other | KS | TAXONOMY |
| 30004842030001 | Medicaid | KS |
| Provider Name | Laveta M Jarrett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588890404 PECOS PAC ID: 8628124229 Enrollment ID: I20090923000641 |
| Provider Name | Evangeline Claire Newsom-white |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245627033 PECOS PAC ID: 9133505662 Enrollment ID: I20221006000261 |
Wichita State University Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1845 Fairmount Box 91, Wichita, KS 67260 Phone: 502-821-7904 | |
Inspire Counseling And Support Center, Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 820 N Main St, Wichita, KS 67203 Phone: 316-202-7051 Fax: 833-213-7988 | |
Wichita Ocd Center Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 560 N Exposition St, Wichita, KS 67203 Phone: 316-854-3520 | |
Manatee Care P.a Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4925 S Broadway Ave Unit 8181, Wichita, KS 67216 Phone: 213-558-4348 | |
Adapt, Grip & Stephenie Roberts, Lscsw Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 9505 W. Central, Ste. 103, Wichita, KS 67212 Phone: 316-721-0971 Fax: 316-512-4070 | |
Counseling & Mediation Center Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 W Douglas Ave Ste 560, Wichita, KS 67202 Phone: 316-269-2322 Fax: 316-269-2448 | |
Family Consultation Service, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 560 N. Exposition, Wichita, KS 67203 Phone: 316-264-8317 Fax: 316-264-0347 |