Individual provider Active NPI

Yvette Goldurs, LISW-S

  • Clinical Social Worker
  • Rocky River, OH
National Provider Identifier
1992058267
Registry record updated Jun 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I-5410 Issued in OH
Practice address
20575 Center Ridge Rd Ste 119
Rocky River, OH 44116-3422
Phone
(216) 526-4208
Fax
(216) 274-6388
NPI assigned
Oct 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 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 I-5410 OH Primary

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
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
I20121220000085 OH Practitioner - Clinical Social Worker 3476705401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

20575 Ctr Ridge Rd
Suite 119
Rocky River, OH 44116-3422
Phone (216) 526-4208

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I-5410OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Yvette Goldurs, Lisw, LLC Clinical CurrentSince Sep 1, 2019 Accepting new patients

Locations

21380 Lorain Rd
Ste 102
Fairview Park, OH 44126
Phone (216) 395-7523

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

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

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": "1350950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717891200000",
    "number": "1992058267",
    "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",
            "fax_number": "216-274-6388"
        },
        {
            "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": "216-274-6388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDURS",
        "first_name": "YVETTE",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-23",
        "last_updated": "2024-06-09",
        "certification_date": "2024-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I-5410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky River, OH

Sources for this page

Verify at the official NPI Registry.