Revere Counseling and Care Management LLC
NPI 1114429412ActiveOrganization· Social Worker· Decatur, GA
Social Worker in Decatur, Georgia, registered in NPPES in March 2018. The authorized official on file is Stephanie Lynn Roach, LCSW, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1114429412 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 2, 2018 |
| Last updated in NPPES | Jul 19, 2022 |
| Certified by provider | Jul 19, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker Primary | 104100000X | CSW002619 | GA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (GA) |
|---|
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