Intent Revival
Social Worker, Clinical in Fort Collins, CO. Organization (NPI-2).
NPI number1457851925
StatusActive
Last updated in NPPESFeb 20, 2018
Details
- NPI
- 1457851925
- Entity type
- Organization (NPI-2)
- Legal business name
- Intent Revival
- Organization subpart
- No
- Enumeration date
- Feb 20, 2018
- Last updated
- Feb 20, 2018
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | CSW.09925190 | CO | Yes |
Practice location
1817 Orchard PlFort Collins, CO 80521-3323
Phone 970-624-9807
Mailing address
1817 Orchard PlFort Collins, CO 80521-3323
Phone 970-624-9807
Authorized official
Freyja May
Registered Agent
9706249807
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