Modern Revival Therapy LLC
NPI 1023958394ActiveOrganization· Social Worker, Clinical· Livonia, MI
Social Worker, Clinical in Livonia, Michigan, registered in NPPES in March 2026. The authorized official on file is Emily Thayer, Owner.
Overview
| NPI | 1023958394 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 30, 2026 |
| Last updated in NPPES | Apr 6, 2026 |
| Certified by provider | Apr 6, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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