Ann Revard, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

50949 Issued in TX

Practice address

1314 Lake St Ste 102
Fort Worth, TX 76102-4582

Phone

(817) 810-0030

Fax

(817) 367-9615

NPI assigned

Mar 19, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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.

Enrollment records 1

Specialty

Clinical Social Worker

Education

University of Southern California Keck School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Huguley Psychotherapy Clinic, Inc.

  • Clinical Social Worker
  • Cleburne, TX
  • NPI 1275707820
  NPD (past)
• Serene Spaces Psychiatry PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Cleburne, TX
  • NPI 1235954223
  NPD (past)
• Stewart Keller DO PA

  • Neurology Physician
  • Fort Worth, TX
  • NPI 1225080856
  NPD (past)

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

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1194996900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 LAKE ST STE 102",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761024582",
            "telephone_number": "817-810-0030",
            "fax_number": "817-367-9615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 LAKE ST STE 102",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761024582",
            "telephone_number": "817-810-0030",
            "fax_number": "817-367-9615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVARD",
        "first_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-19",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "23021",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "50949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "193616302",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul Leroy Retcofsky, A.T.P.
• Retina Consultants PA
• Krista L Rettig, CPNP
• Return 2 PLLC
• Kristen Reuter, LCSW
• Jaime Delynn Revilla
• Revitalize Chiropractic
• Revive Chiropractic LLC
• Reviving Hope Christian Counseling PLLC
• Monika Lucille Revlett, LPN

• Clinical Social Worker in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.