Individual provider Active NPI

Katherine Donohue Yeo, LISW

  • Clinical Social Worker
  • Albuquerque, NM
National Provider Identifier
1003904848
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I-1056 Issued in NM
Practice address
4233 Montgomery Blvd NE Ste 200W
Albuquerque, NM 87109-6707
Phone
(505) 884-8040
Fax
(505) 884-3230
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I-1056 NM Primary

Addresses

Primary practice location

4233 Montgomery Blvd NE Ste 200W
Albuquerque, NM 87109-6707

Mailing address

9125 Alameda Blvd NE
Albuquerque, NM 87122-3707
Phone (505) 843-9572

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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

Enrollment IDStateProvider typePAC IDDetails
I20071116000603 NM Practitioner - Clinical Social Worker 9335237858 Practice locations: Albuquerque, NM

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2201 San Pedro NE
Building 4 Suite 102
Albuquerque, NM 87110-4100

2201 San Pedro NE Dr
BLDG 4 Suite 102
Albuquerque, NM 87110-4100
Phone (505) 884-8040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I-1056NMMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003904848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9125 ALAMEDA BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871223707",
            "telephone_number": "505-843-9572",
            "fax_number": "505-884-3230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4233 MONTGOMERY BLVD NE STE 200W",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871096707",
            "telephone_number": "505-884-8040",
            "fax_number": "505-884-3230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEO",
        "first_name": "KATHERINE",
        "middle_name": "DONOHUE",
        "name_prefix": "Mrs.",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I-1056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.