Individual provider Active NPI

Yiny Poveda, LCSW

  • Clinical Social Worker
  • Lake Mary, FL
National Provider Identifier
1396166849
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW20911 Issued in FL
Practice address
1355 S International Pkwy Ste 1481
Lake Mary, FL 32746-1694
Phone
(407) 559-7011
NPI assigned
Jan 1, 2014
Last updated
Jan 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ISW8365 FL
Clinical Social Worker 1041C0700X SW20911 FL Primary

Addresses

Primary practice location

1355 S International Pkwy Ste 1481
Lake Mary, FL 32746-1694

Mailing address

810 Freemans Farm Rd
Deland, FL 32720-1413
Phone (386) 214-6648

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20230130002725 FL Practitioner - Clinical Social Worker 8022489095 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Moore Medical Group IncGroup PAC ID 9638354889, 18 clinicians
Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

1355 S International Pkwy
Suite 1481
Lake Mary, FL 32746-1694
Phone (407) 559-7011

66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ISW8365FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Mar 5, 2024 Accepting new patients
Moore Medical Group Inc CurrentSince Feb 1, 2023 Accepting new patients
Mental Health Specialty Group PA CurrentSince Aug 1, 2025 Accepting new patients
Moore Medical Group Inc CurrentSince Feb 1, 2023 Accepting new patients

Locations

1355 S International Pkwy
Ste 1481
Lake Mary, FL 32746
Phone (407) 323-1234

1355 S International Pkwy
Ste 1491
Lake Mary, FL 32746
Phone (407) 543-6411

801 International Pkwy
Ste 500
Lake Mary, FL 32746
Phone (407) 562-2000

2328 10th Ave N
Ste 201
Lake Worth, FL 33461
Phone (561) 236-7622

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

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, 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": "1388534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1396166849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 FREEMANS FARM RD",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327201413",
            "telephone_number": "386-214-6648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 S INTERNATIONAL PKWY STE 1481",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327461694",
            "telephone_number": "407-559-7011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POVEDA",
        "first_name": "YINY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-01",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "ISW8365",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW20911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.