Mental Health Pro PA Revived Wellness
NPI 1366310112 · Psychiatric/Mental Health Nurse Practitioner · San Antonio, TX
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Mental Health Pro PA Revived Wellness is a Psychiatric/Mental Health Nurse Practitioner organization in San Antonio, TX (NPI 1366310112).
Provider details
- NPI number
- 1366310112
- Entity type
- Organization
- Primary specialty
- Psychiatric/Mental Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Victoria Abolarin, Owner of Entity(818) 300-9424
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2025-10-24
- Last updated
- 2026-03-05
- Certified
- 2026-03-05
Frequently asked questions
- What is Mental Health Pro PA Revived Wellness's NPI number?
- Mental Health Pro PA Revived Wellness's National Provider Identifier (NPI) is 1366310112, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Mental Health Pro PA Revived Wellness?
- Mental Health Pro PA Revived Wellness is classified in the NPPES registry as Psychiatric/Mental Health Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Mental Health Pro PA Revived Wellness located?
- Mental Health Pro PA Revived Wellness's practice location on file with NPPES is 4400 S Piedras Dr Ste 217, San Antonio, TX 78228-1223.
- What is Mental Health Pro PA Revived Wellness's phone number?
- The practice phone number listed in the NPPES registry for Mental Health Pro PA Revived Wellness is (210) 903-3383.
- Does Mental Health Pro PA Revived Wellness accept Medicare?
- Mental Health Pro PA Revived Wellness is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Mental Health Pro PA Revived Wellness?
- The authorized official listed on Mental Health Pro PA Revived Wellness's NPPES record is Victoria Abolarin, Owner of Entity. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Mental Health Pro PA Revived Wellness's NPI active?
- Yes — Mental Health Pro PA Revived Wellness's NPI (1366310112) is active in the NPPES registry as of the last update on 2026-03-05.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.