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Revival Therapy Services LLC

Counselor, Mental Health in Colorado Springs, CO. Organization (NPI-2).

NPI number1619780145
StatusActive
Last updated in NPPESJan 29, 2025

Details

NPI
1619780145
Entity type
Organization (NPI-2)
Legal business name
Revival Therapy Services LLC
Organization subpart
Yes
Enumeration date
Jan 29, 2025
Certification date
Jan 29, 2025
Last updated
Jan 29, 2025

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 codeDescriptionLicenseStatePrimary
101YM0800X Counselor, Mental Health––Yes

Practice location

3520 Austin Bluffs Pkwy Ste 101
Colorado Springs, CO 80918-5756

Phone 303-551-0117 · Fax 303-551-0117

Mailing address

1133 N Pennsylvania St
Denver, CO 80203-2502

Phone 303-551-0017 · Fax 303-551-0117

Authorized official

Sacha Lacasse
Owner/Director
7204414622

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Mental Health Counselor providers in Colorado Springs, CO

All 1,019 Mental Health Counselor providers in Colorado Springs · All 25,904 providers in Colorado Springs

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