KEN R YODER (LCSW) – Clinical Social Worker, NPI 1104866920

KEN R YODER (LCSW) is a healthcare provider. based in Goshen, Indiana. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 34000514A (IN). The NPI Number for KEN R YODER (LCSW) is 1104866920

Main info

Male
52 Years Of Experience
Accepts Medicare Assignment
Name
KEN R YODER (LCSW)
NPI
1104866920
Phone
(574) 533-1234
Address
330 LAKEVIEW DR
Enumeration Date
8 June 2006
Last Update Date
8 August 2011

Doctor Profile

Medical School Name
UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Secondary Phone
5745331234
Graduation Year
1974 (52 years ago)
PAC ID
6608894340
Group Practice PAC ID
6002801065
Professional Enrollment ID
I20051110000620
Address ID
IN465289365GO330XXDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,711 CLINICAL SOCIAL WORKER in IN

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Provider Addresses for KEN R YODER (LCSW)

  • 330, Lakeview Drive, Maplecrest, Goshen, Elkhart County, Indiana, 46528, United States

    GOSHEN, IN 465289365

    Phone: (574) 533-1234

    Mailing address matches the actual address.

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: 2005-11-10

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
I20051110000620IClinical Social WorkerINTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90834Psychotherapy, 45 minutes12713$0
View full utilization report →

Insurance plans in this area (ZIP 46528)

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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: 6002801065View full group profile
NameSpecialtyState
Mental Health CounselorIN
-IN
Clinical Social WorkerIN
-IN
P S Y C H I A T R YIN
Clinical PsychologistIN
Nurse PractitionerIN
Clinical Social WorkerIN
Nurse PractitionerIN
-IN

Reviews

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Frequently asked questions

How is KEN R YODER (LCSW) identified in CMS data?
CMS-hosted NPPES data lists KEN R YODER (LCSW) with NPI 1104866920.
Does CMS list KEN R YODER (LCSW) as active?
Yes — KEN R YODER (LCSW) is active in the NPI listing used on this page.
What is KEN R YODER (LCSW)'s specialty?
The listing groups KEN R YODER (LCSW) with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where should I expect KEN R YODER (LCSW) on a map?
Expect Goshen, Indiana as a primary anchor for KEN R YODER (LCSW) unless the record lists multiple sites.
Is the information about KEN R YODER (LCSW) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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