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General NPI Number Information
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NPI Number | 1053210518
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Entity Type | Organization
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Legal Business Name | REVOLUTION HEALTH
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Dates
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Enumeration Date | 11/02/2026
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Last Update Date | 11/02/2026
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Provider Practice Location Address
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Address Line | 850 SOUTHBRIDGE ST STE 2
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City | AUBURN
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State | MA
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Zip | 01501-1329
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Country | US
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Telephone | 508-304-5237
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Fax |
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Provider Business Mailing Address
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Address Line | 850 SOUTHBRIDGE ST STE 2
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City | AUBURN
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State | MA
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Zip | 01501-1329
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Country | US
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Telephone | 508-304-5237
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | JESSICA BOVE JAMISON
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Credential | LMHC
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Telephone | 508-304-5237
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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