Individual provider Active NPI

Yolanda Anne Patko, LPC

  • Professional Counselor
  • Fort Worth, TX
National Provider Identifier
1235267170
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
19900 Issued in TX
Practice address
6106 Portico Dr
Fort Worth, TX 76132-4171
Phone
(817) 800-0248
NPI assigned
Mar 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 19900 TX Primary

Addresses

Primary practice location

6106 Portico Dr
Fort Worth, TX 76132-4171

Mailing address

PO Box 22948
Fort Worth, TX 76122-0001
Phone (817) 800-0248

Other identifiers 1

IdentifierTypeStateIssuer
10065842OtherTXAMERIGROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20260430001653 TX Practitioner - Mental Health Counselor 1759858442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2003
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5424 Rufe Snow Dr
Suite 304
North Richland Hills, TX 76180-6635

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19900TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Knight NHCC of NRH LLC Professional 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235267170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22948",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761220001",
            "telephone_number": "817-800-0248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6106 PORTICO DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324171",
            "telephone_number": "817-800-0248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATKO",
        "first_name": "YOLANDA",
        "middle_name": "ANNE",
        "name_prefix": "Prof.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "19900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10065842",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.