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

Revive Behavioral Health, LLC

Organization Psychiatric/Mental Health Nurse Practitioner · NPI 1003601220

Revive Behavioral Health, LLC is a Psychiatric/Mental Health Nurse Practitioner in Mount Vernon, Ohio. Registered with an NPI since 2025.

In the registry since
2025
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

206 S Mulberry St Ste A
Mount Vernon, OH 43050-3331
Phone: (740) 501-4836
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X

Record details

NPI number1003601220
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jordan Moore — Owner · (740) 501-4836
NPI enumeratedApril 9, 2025
Last updated in NPPESApril 10, 2025
Certification dateApril 10, 2025
Mailing address6130 Sharp Rd, Mount Vernon, OH 43050-9477

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