Psych Revival Therapy LLC
NPI 1184447955ActiveOrganization· Social Worker, Clinical· Springfield, MO
Social Worker, Clinical in Springfield, Missouri, registered in NPPES in November 2024. The authorized official on file is Nichole Sprowso, LCSW, Ceo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1184447955 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 1, 2024 |
| Last updated in NPPES | Nov 1, 2024 |
| Certified by provider | Nov 1, 2024 |
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) | Enrolled Part B Supplier - Clinic/Group Practice (MO) |
|---|
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