DR. CAROLL ANN REVAK PH.D. NPI 1205863800

NPI Information

  • NPI: 1205863800
  • Provider Name: DR. CAROLL ANN REVAK, PH.D.
  • Classification: Psychologist - 103TC0700X
  • Specialization: Clinical
  • Entity Type: Individual
  • Address: 1 SAREDON PL
    SUITE 300
    ROCHESTER, NY
    ZIP 14606
  • Phone: (585) 426-8460

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NPI Details

DR. Caroll Ann Revak, PH.D. is a clinical psychologist in Rochester, NY. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. DR. Caroll Ann Revak, PH.D. NPI is 1205863800. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1 SAREDON PL
SUITE 300
ROCHESTER, NY
ZIP 14606-070
Phone: (585) 426-8460
Fax: (585) 426-8460

The enumeration date for this NPI number is 6/27/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TC0700XPsychologistClinical007402-1NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1100242FCOTHERNEW YORKPREFERRED CARE
27700518OTHERNEW YORKDOCTOR'S HEALTH PLAN MVP
37760102OTHERNEW YORKAETNA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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