Individual provider Active NPI

Yonna F Swingholm, LICSW

  • Clinical Social Worker
  • Fayetteville, NC
National Provider Identifier
1124123229
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C011972 Issued in NC
Practice address
2018 Fort Bragg Rd Ste 104B
Fayetteville, NC 28303-7037
Phone
(206) 457-7223
NPI assigned
Sep 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LW00008005 WA
Clinical Social Worker 1041C0700X LCSW68367 CA
Clinical Social Worker 1041C0700X C-11422 NM
Clinical Social Worker 1041C0700X C011972 NC Primary

Addresses

Primary practice location

2018 Fort Bragg Rd Ste 104B
Fayetteville, NC 28303-7037

Mailing address

1000 Cordova PL # 315
Santa Fe, NM 87505-1725
Phone (206) 457-7223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW68367CAMDClinical Social Worker
C011972NCMDClinical Social Worker
C-11422NMMDClinical Social Worker
LW00008005WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Counseling Solutions Clinical Past Accepting new patients

Organizations & group practices 1

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1124123229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 CORDOVA PL # 315",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875051725",
            "telephone_number": "206-457-7223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 FORT BRAGG RD STE 104B",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283037037",
            "telephone_number": "206-457-7223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWINGHOLM",
        "first_name": "YONNA",
        "middle_name": "F",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00008005",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW68367",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-11422",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C011972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.