Active NPI
Marian K V Yacovella, MSW, SWC
- Clinical Social Worker
- Longmont, CO
National Provider Identifier
1235624909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 630 15TH Ave Ste 104
Longmont, CO 80501-2764 - Phone
- (970) 775-7061
- NPI assigned
- Jun 26, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CO | Primary | |
| Case Manager/Care Coordinator | 171M00000X |
Addresses
Primary practice location
630 15TH Ave Ste 104
Longmont, CO 80501-2764
Mailing address
630 15TH Ave Ste 104
Longmont, CO 80501-2764
Phone (330) 725-9195
Other practice location 1
246 Northland Dr Ste 200A
Medina, OH 44256-3440
Phone (330) 725-9195
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kidstuff Child and Family Counseling, P.C. | Clinical | Past | Accepting new patients |
| Kidstuff Child and Family Counseling, P.C. | Clinical | Past | Accepting new patients |
| Kidstuff Child & Family Counseling, P.C. | Past | Accepting new patients | |
| Kidstuff Child and Family Counseling, P.C. | Clinical | Past | Accepting new patients |
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.
-
- Mental Health Counselor
- Fort Collins, CO
- NPI 1073375275
-
- Professional Counselor
- Loveland, CO
- NPI 1184234049
Clinical
-
- Professional Counselor
- Colorado Springs, CO
- NPI 1326798703
Clinical
-
- Professional Counselor
- Greeley, CO
- NPI 1396374237
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686614400000",
"number": "1235624909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 15TH AVE STE 104",
"city": "LONGMONT",
"state": "CO",
"postal_code": "805012764",
"telephone_number": "330-725-9195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 15TH AVE STE 104",
"city": "LONGMONT",
"state": "CO",
"postal_code": "805012764",
"telephone_number": "970-775-7061"
}
],
"practiceLocations": [
{
"address_1": "246 Northland Dr Ste 200A",
"address_purpose": "LOCATION",
"city": "Medina",
"state": "OH",
"postal_code": "442563440",
"country_code": "US",
"telephone_number": "330-725-9195",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "YACOVELLA",
"first_name": "MARIAN",
"middle_name": "K V",
"credential": "MSW, SWC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-26",
"last_updated": "2023-06-13",
"certification_date": "2023-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CO",
"license": null,
"primary": true
},
{
"code": "171M00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Longmont, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.