Organization · Type 2 NPI
Revive Clinic LLC
Psychiatric/Mental Health Clinical Nurse Specialist · Columbia, MD
NPI number
1003797176
Active
Practice location
10440 Little Patuxent Pkwy Ste 300
Columbia, MD 21044-3648
Fax (866) 538-1415
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Clinical Nurse Specialist Primary | 364SP0808X | None listed |
Psychiatric/Mental Health Clinical Nurse Specialist: Definition to come...
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About NPI 1003797176
Revive Clinic LLC's National Provider Identifier is 1003797176, issued on Sep 8, 2025. The primary taxonomy on file is Psychiatric/Mental Health Clinical Nurse Specialist (364SP0808X), and the practice location is in Columbia, MD. The record was last updated on May 12, 2026.