Organization Active NPI

Yvette Goldurs, Lisw, LLC

  • Clinical Social Worker
  • Rocky River, OH
National Provider Identifier
1598327751
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
YVETTE GOLDURS, LISW, LLC
Practice address
20575 Center Ridge Rd Ste 119
Rocky River, OH 44116-3422
Phone
(216) 526-4208
Fax
(216) 274-6388
NPI assigned
Jul 8, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Authorized official

Name
Yvette Goldurs, LISW-SNPI 1992058267
Title
Owner
Phone
(216) 526-4208

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

20575 Center Ridge Rd Ste 119
Rocky River, OH 44116-3422

Mailing address

3867 Glenwood Rd
Cleveland Heights, OH 44121-1649
Phone (216) 526-4208

Other practice location 1

20620 John Carroll Blvd Ste 202
University Heights, OH 44118-4540
Phone (216) 526-4208

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190826003380 OH Part B Supplier - Clinic/Group Practice 0840528022 Receives reassigned benefits from 1 practitioner
Practice locations: Rocky River, OH; University Heights, OH

National Provider Directory

National Provider Directory

Locations

20575 Center Ridge Rd
Ste 119
Rocky River, OH 44116
Phone (216) 526-4208

4325 Mayfield Rd
South Euclid, OH 44121

20620 John Carroll Blvd
Ste 202
University Hts, OH 44118
Phone (216) 395-7144

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1598327751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3867 GLENWOOD RD",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441211649",
            "telephone_number": "216-526-4208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20575 CENTER RIDGE RD STE 119",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441163422",
            "telephone_number": "216-526-4208",
            "fax_number": "216-274-6388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20620 John Carroll Blvd Ste 202",
            "address_purpose": "LOCATION",
            "city": "University Heights",
            "state": "OH",
            "postal_code": "441184540",
            "country_code": "US",
            "telephone_number": "216-526-4208",
            "fax_number": "216-526-4208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "YVETTE GOLDURS, LISW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-08",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "GOLDURS",
        "authorized_official_first_name": "YVETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "216-526-4208",
        "authorized_official_credential": "LISW-S"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky River, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.