Provider Demographics
NPI:1750180048
Name:REVITALIZE COUNSELING SERVICES
Entity type:Organization
Organization Name:REVITALIZE COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:J
Authorized Official - Last Name:SAINT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC, BCBA-D
Authorized Official - Phone:920-284-7950
Mailing Address - Street 1:314 N APPLETON ST
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-4754
Mailing Address - Country:US
Mailing Address - Phone:920-284-7950
Mailing Address - Fax:
Practice Address - Street 1:314 N APPLETON ST
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-4754
Practice Address - Country:US
Practice Address - Phone:920-284-7950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty