ALDO ENRIQUE REVILLA (NPI# 1548771876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548771876 |
| Entity Type | Individual |
| Full Name | ALDO ENRIQUE REVILLA |
| Other Name | ALDO REVILLA |
| Practice Address |
Bermiss Rd, Moody Afb Valdosta GA 31699 |
| Practice Telephone | 2292574211 |
| Mailing Telephone | 2292574211 |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2017-10-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 4858 | PR | Behavioral Health & Social Service Providers |
| Street Address |
BERMISS RD, MOODY AFB |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31699 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699903146 | Elizabeth L Fauber | Military Health Care Provider | 9551 Luke Street, Apo, AP 31699 | 2009-06-23 |
| 1063646230 | James Michael White | Military Health Care Provider | 3278 Mithell Blvd, Bldg. 900, Moody Afb, GA 31699 | 2009-05-04 |
| 1265415590 | Rosalie Andrea Castillo | Family Medicine | 347th Medical Group, 3278 Mitchell Blvd, Valdosta, GA 31699 | 2005-11-21 |
| 1902379555 | Amber Leigh Tordoff | Student in an Organized Health Care Education/Training Program | 23d Medical Group 3278 Mitchell Blvd, Building 900, Apo, AA 31699 | 2019-01-07 |
| 1083147367 | Jordan Robbins | Dentist | 23rd Medical Group 3278 Mitchell Blvd, Moody Afb, GA 31699 | 2017-04-04 |
| 1912350877 | Sandra H Stuart | Dietitian, Registered | 3278 Mitchell Blvd, 23d Medical Group, Valdosta, GA 31699 | 2016-07-15 |
| 1407293418 | Clayton Lively | Psychiatry & Neurology | 3278 Mitchell Blvd, Moody Afb, GA 31699 | 2013-05-30 |
| 1174899371 | Vincent Casey Allen Jr. | Psychologist | 3278 Mitchell Blvd, Moody Afb, GA 31699 | 2012-04-01 |
| 1518364678 | Rachel Collins | Specialist/Technologist | 23 Mdos Sgoy, 3278 Mitchell Blvd, Moody Afb, GA 31699-0001 | 2014-12-04 |
| 1083988356 | Brock Allen Mcnabb | Social Worker | 23rd Medical Group 3278 Mitchell Blvd, Moody Afb, GA 31699-0001 | 2012-03-02 |
| Find all providers in zip 31699 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588194799 | Ryan Couillou | Psychologist | 2704 N Oak St Bldg A1, Valdosta, GA 31602-5901 | 2017-06-20 |
| 1447677828 | Twyla Lucinda Mancil | Psychologist | 202 W Gordon St, Suite D, Valdosta, GA 31601-4569 | 2014-03-24 |
| 1881874618 | Kellie Hyde | Psychologist | 5140 Northwind Blvd, Condo 305 East, Valdosta, GA 31605-4506 | 2007-11-08 |
| 1720003262 | David Thomas Wasieleski | Psychologist | 1002 Slater St, Valdosta, GA 31601-3937 | 2006-07-13 |
| 1790240984 | Jennifer Michelle Branscome | Psychologist | 2236 Bemiss Rd, Valdosta, GA 31602-1942 | 2019-02-01 |
| 1164870408 | Southern Psychological and Behavioral Services, LLC | Psychologist | 202 W Gordon St, Suite D, Valdosta, GA 31601-4569 | 2016-05-26 |
| 1750632279 | Palmtree Psychological Services, LLC | Psychologist | 111 Woodrow Wilson Dr, Suite B, Valdosta, GA 31602-2587 | 2012-09-24 |
| 1225366172 | Marcie C Wiseman | Psychologist | 2704 N Oak St, Building B-3, Valdosta, GA 31602-1744 | 2009-12-03 |
| 1962516625 | Emily Burton | Psychologist | 2841 N Patterson St, Valdosta, GA 31602-1743 | 2006-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568072015 | Karen A Foster | Psychologist | 2115 Dee Dee Muse Ln Nw, Atlanta, GA 30318-1503 | 2020-08-08 |
| 1013525120 | Renato Popovic | Psychologist | 2601 Cross Country Dr, Columbus, GA 31906-1801 | 2020-07-15 |
| 1275159584 | Joe Ann Marie Brandt | Psychologist | 11706 Mercy Blvd Ste 1, Savannah, GA 31419-1751 | 2020-06-23 |
| 1376164863 | Alexander Brikman | Psychologist | 2374 Main St Ste A, Tucker, GA 30084-4533 | 2020-05-06 |
| 1154942084 | Martie Camille Belle | Psychologist | 1462 Clifton Rd Ne Ste 235, Atlanta, GA 30322-1063 | 2020-05-01 |
| 1518513738 | Narjerah Delk | Psychologist | 1226 Anchor Ter Sw, Atlanta, GA 30311-3402 | 2019-08-13 |
| 1043862907 | Lauren Barbara Mcsweeney | Psychologist | 12 Executive Park Dr Ne Ste 3000, Atlanta, GA 30329-2206 | 2019-07-11 |
| 1356907695 | Mc Medical LLC | Psychologist | 3615 Charles Hardy Pkwy Ste 200, Dallas, GA 30157-9472 | 2019-05-13 |
| 1851853758 | Charles A Helm | Psychologist | 116 Preston Landing Cir, Lithia Springs, GA 30122-6846 | 2019-04-01 |
| 1194285106 | Heather Ansari | Psychologist | 3715 Northside Pkwy Nw Ste 605, Atlanta, GA 30327-2886 | 2019-03-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.