Individual provider Active NPI

Yolanda R Saffold, LCSW

  • Clinical Social Worker
  • Racine, WI
National Provider Identifier
1245814581
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10161-123 Issued in WI
Practice address
1717 Taylor Ave
Racine, WI 53403-2405
Phone
(262) 638-6744
Fax
(262) 638-6540
NPI assigned
May 12, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 10161-123 WI Primary

Addresses

Primary practice location

1717 Taylor Ave
Racine, WI 53403-2405

Mailing address

1717 Taylor Ave
Racine, WI 53403-2405

Other identifiers 1

IdentifierTypeStateIssuer
100182546MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20231129000645 WI Practitioner - Clinical Social Worker 1658729850 Reassigns benefits to 1 organization

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
Racine County Finance DepartmentGroup PAC ID 7315857448, 8 clinicians

Practice addresses (Care Compare)

1717 Taylor Ave
Racine, WI 53403-2405
Phone (262) 638-6744

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Racine County Finance Department CurrentSince Sep 25, 2023 Accepting new patients
Family Service of Racine PastSince May 1, 2021 Accepting new patients

Locations

1717 Taylor Ave
Racine, WI 53403
Phone (262) 638-6635

Organizations & group practices 2

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": "1620777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1245814581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 TAYLOR AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534032405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 TAYLOR AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534032405",
            "telephone_number": "262-638-6744",
            "fax_number": "262-638-6540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAFFOLD",
        "first_name": "YOLANDA",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-12",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "10161-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100182546",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

Verify at the official NPI Registry.