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General NPI Number Information
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NPI Number | 1679439061
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Entity Type | Organization
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Legal Business Name | REVIVE, PLLC
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Dates
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Enumeration Date | 12/29/2025
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 1238 HENDERSONVILLE RD STE 220
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City | ASHEVILLE
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State | NC
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Zip | 28803-2779
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Country | US
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Telephone | 910-546-2759
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Fax |
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Provider Business Mailing Address
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Address Line | 181 ASHE BRIDGE RD
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City | MARION
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State | NC
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Zip | 28752-8813
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Country | US
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Telephone | 910-546-2759
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICAL SOCIAL WORKER
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Name | CRISTEN DELANEY WISOR
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Credential | LCSW
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Telephone | 910-546-2759
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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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