MEDICARE: MS. ANDALA YAKUBU APSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	12238123	WI

General Provider Information

NPI Number	:	1942994264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANDALA YAKUBU APSW

Provider Business Mailing Address
First Line	:	815 FORWARD DR
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53711-2443
Country	:	US
Telephone Number	:	608-286-6530
Fax Number	:	608-709-1744

Provider Business Practice Location Address
First Line	:	815 FORWARD DRIVE
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53711-2443
Country	:	US
Telephone Number	:	608-268-6530
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2023
Last Update Date	:	01/20/2026

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