Life Revival LLC
Life Revival LLC is a Mental Health Counselor in Philadelphia, Pennsylvania. Registered with an NPI since 2023.
- In the registry since
- 2023
- Specialties on file
- 15
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
6404 Roosevelt BlvdPhiladelphia, PA 19149-2943
Phone: (267) 577-7747
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Community/Behavioral Health Agency (primary) | Taxonomy 251S00000X |
|---|---|
| Mental Health Counselor | Taxonomy 101YM0800X |
| Counseling Psychologist | Taxonomy 103TC1900X |
| Family Psychologist | Taxonomy 103TF0000X |
| Psychoanalysis Psychologist | Taxonomy 103TP0814X |
| Group Psychotherapy Psychologist | Taxonomy 103TP2701X |
| Clinical Social Worker | Taxonomy 1041C0700X |
| Psychiatry Physician | Taxonomy 2084P0800X |
| Child & Adolescent Psychiatry Physician | Taxonomy 2084P0804X |
| Geriatric Psychiatry Physician | Taxonomy 2084P0805X |
| Case Management Agency | Taxonomy 251B00000X |
| Mental Health Clinic/Center (Including Community Mental Health Center) | Taxonomy 261QM0801X |
| Adult Mental Health Clinic/Center | Taxonomy 261QM0850X |
| Adolescent and Children Mental Health Clinic/Center | Taxonomy 261QM0855X |
| Psychiatric/Mental Health Nurse Practitioner | Taxonomy 363LP0808X |
Record details
| NPI number | 1023701067 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Daniel Lee — Director · (267) 259-4558 |
| Other names | Life Revival, Llc |
| NPI enumerated | May 26, 2023 |
| Last updated in NPPES | February 11, 2025 |
| Certification date | February 11, 2025 |
| Mailing address | 6404 Roosevelt Blvd, Philadelphia, PA 19149-2943 |
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