| Revivication Counseling Services | |
|
321 N Main St Suite C Suffolk VA 23434-4422 | |
| (727) 477-0102 | |
| (757) 477-0142 |
| Full Name | Revivication Counseling Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 321 N Main St Suite C, Suffolk, Virginia |
| Authorized Official Name and Position | Leviticus Lofton (CEO) |
| Authorized Official Contact | 7574470102 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revivication Counseling Services Po Box 1211 Suffolk VA 23439 Ph: (757) 477-0102 | Revivication Counseling Services 321 N Main St Suite C Suffolk VA 23434-4422 Ph: (727) 477-0102 |
| NPI Number | 1912561713 |
|---|---|
| Provider Enumeration Date | 04/26/2019 |
| Last Update Date | 03/21/2022 |
| Certification Date | 03/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912561713 | NPI | - | NPPES |
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