Organization · Type 2 NPI

Modern Revival Therapy LLC

Clinical Social Worker · Livonia, MI

NPI number 1023958394 Active

Practice location

31560 Schoolcraft Rd
Livonia, MI 48150-1805

Call (989) 619-2641 Map

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XNone listed

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1023958394

Modern Revival Therapy LLC's National Provider Identifier is 1023958394, issued on Mar 30, 2026. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Livonia, MI. The record was last updated on Apr 6, 2026.