Individual provider Active NPI

Yineiry Triguero, LCSW

  • Clinical Social Worker
  • Fayetteville, NC
National Provider Identifier
1194390104
Registry record updated Apr 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C016639 Issued in NC
Practice address
806 Hay St
Fayetteville, NC 28305-5312
Phone
(910) 860-7008
NPI assigned
May 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Mental Health Counselor 101YM0800X P017549 NC
Clinical Social Worker 1041C0700X C016639 NC Primary

Addresses

Primary practice location

806 Hay St
Fayetteville, NC 28305-5312

Mailing address

806 Hay St
Fayetteville, NC 28305-5312
Phone (910) 860-7008

Other identifiers 1

IdentifierTypeStateIssuer
15655034OtherNCCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20240327003038 NC Practitioner - Clinical Social Worker 6406293398 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Behavioral Care of North Carolina PCGroup PAC ID 5092120030, 175 clinicians

Practice addresses (Care Compare)

7400 Carmel Executive Park Dr
Suite 155
Charlotte, NC 28226-8242
Phone (336) 944-6522

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P017549NCMDMental Health Counselor
C016639NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Haymount Institute for Psychological Services, PLLC Mental Health CurrentSince Jan 9, 2024 Accepting new patients
Optum Behavioral Care of North Carolina, PC CurrentSince Jun 14, 2024 Accepting new patients
Haymount Institute for Psychological Services, PLLC Mental Health CurrentSince Jan 9, 2024 Accepting new patients
Optum Behavioral Care of North Carolina, P.C. Clinical CurrentSince Jun 14, 2024 Accepting new patients

Locations

1101 Marco Dr
Ste 200
Apex, NC 27502
Phone (844) 534-7202

7400 Carmel Executive Park Dr
Ste 155
Charlotte, NC 28226
Phone (844) 534-7208

231 Meed Ct
Ste 201
Fayetteville, NC 28303
Phone (828) 232-8934

806 Hay St
Fayetteville, NC 28305
Phone 9108607008117

131 W Edinborough Ave
Raeford, NC 28376
Phone (910) 848-1222

Organizations & group practices 4

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": "1621555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712966400000",
    "number": "1194390104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 HAY ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055312",
            "telephone_number": "910-860-7008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 HAY ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055312",
            "telephone_number": "910-860-7008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIGUERO",
        "first_name": "YINEIRY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-21",
        "last_updated": "2024-04-13",
        "certification_date": "2024-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "P017549",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C016639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "15655034",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.