Individual provider Active NPI

Steven Patrick Yerka, LICSW

  • Clinical Social Worker
  • Willmar, MN
National Provider Identifier
1518259266
Registry record updated Jul 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22296 Issued in MN
Practice address
1125 6TH St SE
Willmar, MN 56201-4675
Phone
(320) 235-4613
NPI assigned
May 12, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2014

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 22296 MN Primary

Addresses

Primary practice location

1125 6TH St SE
Willmar, MN 56201-4675

Mailing address

1125 6TH St SE
PO Box 787
Willmar, MN 56201-4675
Phone (320) 235-4613

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20171129003709 ID Practitioner - Clinical Social Worker 2365662657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
May accept Medicare assignment
Group practices
Mental Health SpecialistsGroup PAC ID 1658665427, 11 clinicians

Practice addresses (Care Compare)

210 W Burnside Ave
Suite a
Pocatello, ID 83202-4916
Phone (208) 238-9000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22296MNMDClinical Social Worker

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406505600000",
    "number": "1518259266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 6TH ST SE",
            "address_2": "PO BOX 787",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562014675",
            "telephone_number": "320-235-4613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 6TH ST SE",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562014675",
            "telephone_number": "320-235-4613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YERKA",
        "first_name": "STEVEN",
        "middle_name": "PATRICK",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-12",
        "last_updated": "2014-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "22296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willmar, MN

Sources for this page

Verify at the official NPI Registry.