Yvette Mardis, PH.D., LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R023446 Issued in NY

Practice address

11021 73Rd Rd
Suite 1J
Forest Hills, NY 11375-6348

Phone

(718) 699-8838

Fax

(718) 699-8838

NPI assigned

Oct 17, 2005

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Dr. Rimma Danov Neuropsychologist, PC

  • Clinical Neuropsychologist
  • Staten Island, NY
  • NPI 1275559981
  NPD (past)

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418601600000",
    "number": "1013906767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11021 73RD RD",
            "address_2": "1J",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113756348",
            "telephone_number": "718-699-8838",
            "fax_number": "718-699-8838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11021 73RD RD",
            "address_2": "SUITE 1J",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113756348",
            "telephone_number": "718-699-8838",
            "fax_number": "718-699-8838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARDIS",
        "first_name": "YVETTE",
        "name_prefix": "Dr.",
        "credential": "PH.D., LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-17",
        "last_updated": "2014-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R023446",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005483",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wilson Zhi-Yuan Mar, MD
• Andrew Maran, MD
• Kym Marc
• Marcella Rangel, DPT, P.C.
• Stephanie Marchetti
• Margie R. Solovay
• Michael Richard Margiloff, DDS
• Marina Margolin, MD
• Kayla Jean Marinello
• John Marini

• Clinical Social Worker in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.