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General NPI Number Information
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NPI Number | 1295390094
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Entity Type | Organization
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Legal Business Name | REVOLUTION COUNSELING AND WELLNESS LLC
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Dates
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Enumeration Date | 05/07/2019
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 213 W INSTITUTE PL STE 500
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City | CHICAGO
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State | IL
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Zip | 60610-8792
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Country | US
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Telephone | 872-205-9035
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Fax |
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Provider Business Mailing Address
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Address Line | 9212 BENT MOUNTAIN RD
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City | BENT MOUNTAIN
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State | VA
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Zip | 24059-2350
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Country | US
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Telephone | 872-205-9035
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DARIA HOEY
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Credential | LCSW
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Telephone | 773-597-7834
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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