NPIMap

Organization Active NPI

Yvonne Fellers Inc

  • Clinical Social Worker
  • Texarkana, TX
National Provider Identifier
1083689285
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SO2023 Issued in TX
Legal business name
YVONNE FELLERS INC
Practice address
3400 St Michael Drive
Texarkana, TX 75503
Phone
(903) 838-3322
Fax
(903) 838-9034
NPI assigned
Feb 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. E Yvonne Fellers, LCSW
Title
President and Clinician
Phone
(903) 838-3322

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X SO2023 TX Primary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X C 589 AR

Addresses

Primary practice location

3400 St Michael Drive
Texarkana, TX 75503

Mailing address

PO Box 6447
Texarkana, TX 75505
Phone (903) 838-3322

National Provider Directory

National Provider Directory

Locations

3400 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 838-3322

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083689285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6447",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "75505",
            "telephone_number": "903-838-3322",
            "fax_number": "903-838-9034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 ST MICHAEL DRIVE",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "75503",
            "telephone_number": "903-838-3322",
            "fax_number": "903-838-9034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YVONNE FELLERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FELLERS",
        "authorized_official_first_name": "E",
        "authorized_official_middle_name": "YVONNE",
        "authorized_official_title_or_position": "PRESIDENT AND CLINICIAN",
        "authorized_official_telephone_number": "903-838-3322",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "SO2023",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "C 589",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.