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Revive & Thrive Mental Health, LLC

Psychiatric/Mental Health Nurse Practitioner in Wichita, KS · enumerated 2021 · authorized official Evangeline Newsom, Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1356003628

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Registry record

Entity type Organization (Type 2)
Legal business name Revive & Thrive Mental Health, LLC
Practice address 4013 N Ridge Rd Ste 110, Wichita, KS, 67205
Phone (316) 631-2454
Fax (316) 247-6062
Enumeration date Oct 13, 2021
Last updated in NPPES Jul 7, 2024

Taxonomy & classification

101YA0400X Addiction (Substance Use Disorder) Counselor Behavioral Health & Social Service Providers Secondary
101YM0800X Mental Health Counselor Behavioral Health & Social Service Providers Secondary
101YP2500X Professional Counselor Behavioral Health & Social Service Providers Secondary
103T00000X Psychologist Behavioral Health & Social Service Providers Secondary
103TB0200X Cognitive & Behavioral Psychologist Behavioral Health & Social Service Providers Secondary
103TC0700X Clinical Psychologist Behavioral Health & Social Service Providers Secondary
103TC1900X Counseling Psychologist Behavioral Health & Social Service Providers Secondary
103TC2200X Clinical Child & Adolescent Psychologist Behavioral Health & Social Service Providers Secondary
104100000X Social Worker Behavioral Health & Social Service Providers Secondary
1041C0700X Clinical Social Worker Behavioral Health & Social Service Providers Secondary
106H00000X Marriage & Family Therapist Behavioral Health & Social Service Providers Secondary
251S00000X Community/Behavioral Health Agency Agencies Secondary
261QM0850X Adult Mental Health Clinic/Center Ambulatory Health Care Facilities Secondary
261QM0855X Adolescent and Children Mental Health Clinic/Center Ambulatory Health Care Facilities Secondary
363LP0808X Psychiatric/Mental Health Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Primary

Authorized official

Name Evangeline Newsom
Title Owner
Phone (316) 201-6294

Other identifiers

Identifier Type State Issuer
30004830030002 Medicaid KS -
363LP0808X Other KS TAXONOMY
30004842030001 Medicaid KS -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.
What type of organization is Revive & Thrive Mental Health, LLC?
Revive & Thrive Mental Health, LLC is registered in NPPES as a Psychiatric/Mental Health Nurse Practitioner (its primary provider taxonomy).

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2024-07-07.