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

Revive Life LLC

Organization Psychologist · NPI 1740081223

Revive Life LLC is a Psychologist in Gaithersburg, Maryland. Registered with an NPI since 2025.

In the registry since
2025
Specialties on file
4
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

316 E Diamond Ave
Gaithersburg, MD 20877-3070
Phone: (206) 898-5432
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Multi-Specialty Clinic/Center (primary) Taxonomy 261QM1300X
Psychologist Taxonomy 103T00000X
Clinical Social Worker Taxonomy 1041C0700X
Psychiatry Physician Taxonomy 2084P0800X

Record details

NPI number1740081223
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Radhika Nataraj — Authorized Official · (301) 252-1866
NPI enumeratedMarch 21, 2025
Last updated in NPPESMarch 25, 2026
Certification dateMarch 25, 2026
Mailing address316 E Diamond Ave, Gaithersburg, MD 20877-3070

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