Individual provider Active NPI

Angela Bianca Pullen Yant, MSW, LCSW

  • Clinical Social Worker
  • Cape Girardeau, MO
National Provider Identifier
1053673285
Registry record updated Jun 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2011018250 Issued in MO
Practice address
619 N Broadview St
Cape Girardeau, MO 63701-4313
Phone
(573) 334-3486
Fax
(573) 334-3524
NPI assigned
Jun 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2012

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 2011018250 MO Primary

Addresses

Primary practice location

619 N Broadview St
Cape Girardeau, MO 63701-4313

Mailing address

619 N Broadview St
Cape Girardeau, MO 63701-4313
Phone (573) 334-3486

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20130114000420 MO Practitioner - Clinical Social Worker 9133372576 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.16 of 100Reported as group
Quality
80.99
Improvement activities
40
Cost
72.05

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2011018250MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Deer Oaks Mental Health Associates PC CurrentSince May 15, 2024 Accepting new patients
New Vision Youth and Family Services Inc Clinical PastSince May 1, 2002 Accepting new patients

Locations

1300 County Farm Rd
Cassville, MO 65625
Phone (417) 847-3386

7272 Wurzbach Rd
Ste 601
San Antonio, TX 78240
Phone (210) 615-3472

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339545600000",
    "number": "1053673285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 N BROADVIEW ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637014313",
            "telephone_number": "573-334-3486",
            "fax_number": "573-334-3524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 N BROADVIEW ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637014313",
            "telephone_number": "573-334-3486",
            "fax_number": "573-334-3524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANT",
        "first_name": "ANGELA",
        "middle_name": "BIANCA PULLEN",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-13",
        "last_updated": "2012-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2011018250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.