Revive Family Counseling, L.L.C.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

REVIVE FAMILY COUNSELING, L.L.C.

Practice address

8981 Daniels Center Dr Ste 209
Fort Myers, FL 33912-0308

Phone

(239) 329-9264

NPI assigned

Oct 28, 2021

Organization subpart

No

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

Authorized official

Name

Mrs. Edita Hall, MSNPI 1861985947

Title

LMFT

Phone

(239) 329-9264

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vanessa Anne Garza

  • Marriage & Family Therapist
  • Fort Myers, FL
  • NPI 1508603838
  Medicare reassignment Care Compare group NPD
• Melissa Thompson, LCSW- QS

  • Clinical Social Worker
  • Fort Myers, FL
  • NPI 1720639065
  Medicare reassignment Care Compare group NPD
• Edita Hall

  • Mental Health Counselor
  • Fort Myers, FL
  • NPI 1861985947
  NPD Authorized official
• Jordan Montgomery

  • Marriage & Family Therapist
  • Tampa, FL
  • NPI 1245671759
  NPD (past)

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

{
    "created_epoch": "1635379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763424000000",
    "number": "1881358455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13852 ROSEWATER CT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339130057",
            "telephone_number": "239-329-9264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8981 DANIELS CENTER DR STE 209",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339120308",
            "telephone_number": "239-329-9264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE FAMILY COUNSELING, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-28",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "EDITA",
        "authorized_official_title_or_position": "LMFT",
        "authorized_official_telephone_number": "239-329-9264",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirby Retzer
• Cori J. Revak, PSY.D.
• Tifani Megan Revels Lee, LMT
• Revitalize Counseling
• Revitalize Health Center LLC
• Revive Pharmacy Inc
• Manuel Revuelta, MD
• Gustavo Rey, MD
• Eric W Reyes Grajales, M.D.
• Danny Reyes Lopez

• Mental Health Counselor in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.