Provider Demographics
NPI:1356134613
Name:REVIVE WOMENS THERAPY LLC
Entity type:Organization
Organization Name:REVIVE WOMENS THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPENFUSS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:610-256-1828
Mailing Address - Street 1:1442 POTTSTOWN PIKE UNIT 3014
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-1271
Mailing Address - Country:US
Mailing Address - Phone:610-256-1828
Mailing Address - Fax:
Practice Address - Street 1:209 WOODCREST RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-7929
Practice Address - Country:US
Practice Address - Phone:610-256-1828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)