Revolutionary Wellness, PLLC
NPI 1609311455 · Adolescent and Children Mental Health Clinic/Center · Georgetown, TX
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Revolutionary Wellness, PLLC is a Adolescent and Children Mental Health Clinic/Center organization in Georgetown, TX (NPI 1609311455).
Provider details
- NPI number
- 1609311455
- Entity type
- Organization
- Primary specialty
- Adolescent and Children Mental Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Lisa Margraves, Managing Partner(512) 569-4017
Specialties & taxonomies
Ambulatory Health Care Facilities
- Adult Mental Health Clinic/Center261QM0850X
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
- Clinical Social Worker1041C0700X
Behavioral Health & Social Service Providers
- Professional Counselor101YP2500X
Behavioral Health & Social Service Providers
- Community/Behavioral Health Agency251S00000X
Agencies
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES 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
- 2017-01-04
- Last updated
- 2025-11-10
- Certified
- 2025-11-10
Frequently asked questions
- What is Revolutionary Wellness, PLLC's NPI number?
- Revolutionary Wellness, PLLC's National Provider Identifier (NPI) is 1609311455, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Revolutionary Wellness, PLLC?
- Revolutionary Wellness, PLLC is classified in the NPPES registry as Adolescent and Children Mental Health Clinic/Center (Ambulatory Health Care Facilities).
- Where is Revolutionary Wellness, PLLC located?
- Revolutionary Wellness, PLLC's practice location on file with NPPES is 213 Sinuso Dr, Georgetown, TX 78628-1533.
- What is Revolutionary Wellness, PLLC's phone number?
- The practice phone number listed in the NPPES registry for Revolutionary Wellness, PLLC is (512) 569-4017.
- Does Revolutionary Wellness, PLLC accept Medicare?
- Revolutionary Wellness, PLLC 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 Revolutionary Wellness, PLLC?
- The authorized official listed on Revolutionary Wellness, PLLC's NPPES record is Lisa Margraves, Managing Partner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Revolutionary Wellness, PLLC's NPI active?
- Yes — Revolutionary Wellness, PLLC's NPI (1609311455) is active in the NPPES registry as of the last update on 2025-11-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.