Dr Yvonne Adassa Commodore, EDD, EDS, LISW-C is a
Social Worker - Clinical based in Coward, South Carolina. Dr Yvonne Adassa Commodore is licensed to practice in South Carolina (license number 18153) and her current practice location is
4029 Mcgee Rd, Coward, South Carolina. She can be reached at her office (for appointments etc.) via phone at
(843) 767-7624.
NPI number for Dr Yvonne Adassa Commodore is 1063835445 and her current mailing address is Po Box 62, Lake City, South Carolina. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1063835445.
Healthcare Provider's Profile
| Full Name | Dr Yvonne Adassa Commodore |
|---|
| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 4029 Mcgee Rd, Coward, South Carolina |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1063835445
- Provider Enumeration Date: 01/21/2014
- Last Update Date: 08/14/2025
Medical Identifiers
Medical identifiers for Dr Yvonne Adassa Commodore such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1063835445 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | 188020 (South Carolina) | Secondary |
| 101YM0800X | Counselor - Mental Health | 188020 (South Carolina) | Secondary |
| 104100000X | Social Worker | 188020 (South Carolina) | Secondary |
| 1041S0200X | Social Worker - School | 188020 (South Carolina) | Secondary |
| 1041C0700X | Social Worker - Clinical | 18153 (South Carolina) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Yvonne Adassa Commodore is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Yvonne Adassa Commodore, EDD, EDS, LISW-C
Po Box 62,
Lake City, SC 29560-0062
Ph: (803) 321-6657 | Dr Yvonne Adassa Commodore, EDD, EDS, LISW-C
4029 Mcgee Rd,
Coward, SC 29530-5232
Ph: (843) 767-7624 |
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