Individual provider Active NPI

Yael Oliva, LCSW

  • Clinical Social Worker
  • Farmington, NM
National Provider Identifier
1508482779
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SWB-2023-0982 Issued in NM
Practice address
5600 Mickey Dr Ste B
Farmington, NM 87402-4543
Phone
(505) 793-6099
Fax
(505) 675-2737
NPI assigned
Jun 23, 2020
Last updated
May 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2024

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 SWB-2023-0982 NM Primary

Addresses

Primary practice location

5600 Mickey Dr Ste B
Farmington, NM 87402-4543

Mailing address

3030 E Main St Ste A20 1034
Farmington, NM 87402-4543
Phone (505) 947-9990

Other practice location 1

5600 Mickey Dr Ste C
Farmington, NM 87402-4543
Phone (505) 947-9990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20240117000088 NM Practitioner - Clinical Social Worker 1759733686 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Farmington, NM 87401
Phone (505) 556-2650

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SWB-2023-0982NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Transformation in Therapy Clinical CurrentSince Nov 6, 2023 Accepting new patients
Atb Behavioral Health Services, PC PastSince Jun 1, 2020 Accepting new patients

Locations

3030 E Main St
Ste A20
Farmington, NM 87402

5600 Mickey Dr
Ste B
Farmington, NM 87402
Phone (505) 793-6099

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, 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": "1592870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1508482779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 E MAIN ST STE A20 1034",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874024543",
            "telephone_number": "505-947-9990",
            "fax_number": "505-675-2737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 MICKEY DR STE B",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874024543",
            "telephone_number": "505-793-6099",
            "fax_number": "505-675-2737"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5600 Mickey Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "NM",
            "postal_code": "874024543",
            "country_code": "US",
            "telephone_number": "505-947-9990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLIVA",
        "first_name": "YAEL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-23",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "SWB-2023-0982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

Verify at the official NPI Registry.