Revive Wellness Center
NPI 1205675238ActiveOrganization· Counselor, Professional· Wilmington, NC
Counselor, Professional in Wilmington, North Carolina, registered in NPPES in May 2024. The authorized official on file is Breeana Kennedy, LCMHC, Clinical Counselor.
Overview
| NPI | 1205675238 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 20, 2024 |
| Last updated in NPPES | Sep 17, 2026 |
| Certified by provider | Sep 17, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor, Professional Primary | 101YP2500X | — | — |
| Counselor | 101Y00000X | — | — |
| Counselor, Mental Health | 101YM0800X | — | — |
| Social Worker | 104100000X | — | — |
| Social Worker, Clinical | 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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