Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ann Revard, LCSW

Individual provider Clinical Social Worker · NPI 1194996900

Ann Revard, LCSW is a Clinical Social Worker in Fort Worth, Texas. Graduated from University of Southern California Keck School of Medicine in 2002, 24 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in California and Texas.

Years since qualifying
24
Trained at
University of Southern California Keck School of Medicine
Licensed in
CA, TX
In the registry since
2008
Specialties on file
2
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

1314 Lake St Ste 102
Fort Worth, TX 76102-4582
Phone: (817) 810-0030
Fax: (817) 367-9615
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 50949 (TX)
Clinical Social Worker Taxonomy 1041C0700X · Licence 23021 (CA)

Record details

NPI number1194996900
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedMarch 19, 2008
Last updated in NPPESAugust 7, 2025
Certification dateAugust 7, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolUNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Graduated 2002 (24 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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