YVONNE LICAVOLI – Professional Counselor, NPI 1760113005

YVONNE LICAVOLI is a healthcare provider. based in Fairview heights, Illinois. specializing in MENTAL HEALTH COUNSELOR. They hold a License No. 178015261 (IL). The NPI Number for YVONNE LICAVOLI is 1760113005

Main info

Female
Sole Proprietor
7 Years Of Experience
Accepts Medicare Assignment
Name
YVONNE LICAVOLI
NPI
1760113005
Phone
(314) 397-1428
Address
9626 RIDGE HEIGHTS RD
Enumeration Date
17 June 2022
Last Update Date
17 June 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6186413588
Graduation Year
2019 (7 years ago)
PAC ID
9739696311
Group Practice PAC ID
5698144608
Professional Enrollment ID
I20250729001091
Address ID
IL622268310SW209XXDRXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

2,307 MENTAL HEALTH COUNSELOR in IL

Provider Addresses for YVONNE LICAVOLI

  • 9626 RIDGE HEIGHTS RD

    FAIRVIEW HEIGHTS, IL 622082319

    Phone: (314) 397-1428

    Type: Mailing

  • 4509 N ILLINOIS ST STE 4

    SWANSEA, IL 622261524

    Phone: (314) 669-5060

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-07-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250729001091IMental Health CounselorILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 62208)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5698144608View full group profile
NameSpecialtyState
Nurse PractitionerMO

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Frequently asked questions

What federal number belongs to YVONNE LICAVOLI?
The federal identifier for YVONNE LICAVOLI is NPI 1760113005.
Is YVONNE LICAVOLI active in the national directory?
YVONNE LICAVOLI's public NPI profile is in an active state.
What does YVONNE LICAVOLI treat or focus on?
Patients typically see YVONNE LICAVOLI under the specialty Professional Counselor. Clinical services aligned with this taxonomy classification.
Where does public data place YVONNE LICAVOLI?
The snapshot lists Fairview Heights, Illinois for YVONNE LICAVOLI; download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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