Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Yvonne Licavoli

Individual provider Professional Counselor · NPI 1760113005

Yvonne Licavoli is a Mental Health Counselor in Swansea, Illinois. Qualified in 2019, 7 years ago. Practices with Optimum Mental Health Healing, a 3-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
7
Licensed in
IL
In the registry since
2022
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Practice location Address checks out

4509 N Illinois St Ste 4
Swansea, IL 62226-1524
Phone: (314) 669-5060
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 178015261 (IL)

Record details

NPI number1760113005
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJune 17, 2022
Last updated in NPPESJune 17, 2022
Certification dateJune 17, 2022
Mailing address9626 Ridge Heights Rd, Fairview Heights, IL 62208-2319

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Optimum Mental Health Healing — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Swansea