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

Londa Lynne Revis, LCSW

Individual provider Social Worker · NPI 1912177486

Londa Lynne Revis, LCSW is a Clinical Social Worker in Conway, Arkansas. Qualified in 1992, 34 years ago. Practices with Tilley Family Medicine PA, a 4-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Arkansas.

Years since qualifying
34
Licensed in
AR
In the registry since
2008
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

495 Hogan Ln Ste 2
Conway, AR 72034-8498
Phone: (501) 358-6695
Fax: (501) 358-6860
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence 2212-C (AR)

Record details

NPI number1912177486
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedMarch 11, 2008
Last updated in NPPESSeptember 30, 2020
Certification dateSeptember 30, 2020

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1992 (34 years in practice)
Group practice Tilley Family Medicine Pa — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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