Provider Demographics
NPI:1437947249
Name:REVELATION COUNSELING, LLC
Entity type:Organization
Organization Name:REVELATION COUNSELING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CADWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC/S
Authorized Official - Phone:803-859-4496
Mailing Address - Street 1:1750 W HWY 160 STE. 101 PMB 251
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-8009
Mailing Address - Country:US
Mailing Address - Phone:803-859-4496
Mailing Address - Fax:
Practice Address - Street 1:7000 PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226
Practice Address - Country:US
Practice Address - Phone:803-859-4496
Practice Address - Fax:803-266-6912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-30
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty