Cori J. Revak, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY6814 Issued in FL

Practice address

13430 Parker Commons Blvd Ste 101
Fort Myers, FL 33912-1812

Phone

(239) 561-9955

Fax

(239) 561-9779

NPI assigned

Sep 29, 2006

Last updated

May 12, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Cori Calkins Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jun 16, 2015 through Jun 16, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Associates in Family Psychology

  • Clinical Psychologist
  • Fort Myers, FL
  • NPI 1275712911
  NPD
• Pooja Shastri, Psy.D., P.a.

  • Clinical Psychologist
  • Fort Myers, FL
  • NPI 1891334157
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1740372325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13430 PARKER COMMONS BLVD STE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339121812",
            "telephone_number": "239-561-9955",
            "fax_number": "239-561-9779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13430 PARKER COMMONS BLVD STE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339121812",
            "telephone_number": "239-561-9955",
            "fax_number": "239-561-9779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVAK",
        "first_name": "CORI",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY6814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP PROVIDER #",
            "identifier": "74976",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVID. PROVIDER #",
            "identifier": "74376",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORI",
            "last_name": "CALKINS",
            "credential": "PSYD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nicholas Ressa, M.D.
• Gerardo David Resto Santos
• Noah Resuta, DPT
• Retina Health Center PL
• Kirby Retzer
• Tifani Megan Revels Lee, LMT
• Revitalize Counseling
• Revitalize Health Center LLC (Revitalize Health Care Center of Fort Myers)
• Revive Family Counseling, L.L.C.
• Revive Pharmacy Inc (Revive Pharmacy)

• Clinical Psychologist in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.