Revive Wellness
Revive Wellness is a healthcare organization registered as Mental Health Clinic/Center (Including Community Mental Health Center) in Crookston, MN, holding Type 2 (organization) NPI 1639885171 since 2023. The authorized official on file is Jessica Shockman, Mental Health Professional.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1639885171 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Revive Wellness |
| Practice address | 116 W ROBERT ST STE 2B, Crookston, MN, 56716 |
| Phone | 2182897023 |
| Enumeration date | 2023-01-27 |
| Last updated in NPPES | 2023-01-27 |
Authorized official
| Name | Jessica Shockman |
|---|---|
| Title | Mental Health Professional |
| Phone | 2182897023 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | Primary | — | — |
Copy-ready billing details
Provider: Revive Wellness NPI: 1639885171 Taxonomy: 261QM0801X (Mental Health Clinic/Center (Including Community Mental Health Center)) Address: 116 W ROBERT ST STE 2B, Crookston, MN, 56716
Verify this record
Cross-check NPI 1639885171 against the authoritative CMS record: view Revive Wellness on the official NPPES registry .
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. Read the full guide or validate an NPI number.
Frequently asked questions
Who is the authorized official for Revive Wellness?
What is the NPI number for Revive Wellness?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2023-01-27.