Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Modern Revival Therapy LLC

Organization Clinical Social Worker · NPI 1023958394

Modern Revival Therapy LLC is a Clinical Social Worker in Livonia, Michigan. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

31560 Schoolcraft Rd
Livonia, MI 48150-1805
Phone: (989) 619-2641
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X

Record details

NPI number1023958394
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Emily Thayer — Owner · (989) 619-2641
NPI enumeratedMarch 30, 2026
Last updated in NPPESApril 6, 2026
Certification dateApril 6, 2026
Mailing address31560 Schoolcraft Rd, Livonia, MI 48150-1805

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