Individual provider Active NPI

Christine Anne O'Toole, LCSW

  • Clinical Social Worker
  • Sierra Vista, AZ
National Provider Identifier
1003465600
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.021531 Issued in IL
Practice address
77 Calle Portal Ste C240
Sierra Vista, AZ 85635-2986
Phone
(520) 515-8669
NPI assigned
Sep 5, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.021531 IL Primary

Addresses

Primary practice location

77 Calle Portal Ste C240
Sierra Vista, AZ 85635-2986

Mailing address

1133 W Wilson St Apt C
Batavia, IL 60510-1884
Phone (630) 770-6841

Other practice location 1

111 E Main St
St Charles, IL 60174-1948
Phone (630) 587-3777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230310002074 AZ Practitioner - Clinical Social Worker 6002289170

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.021531ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Chiricahua Community Health Centers Inc CurrentSince Dec 12, 2022 Accepting new patients
Chiricahua Community Health Centers, Inc Current Accepting new patients
Chiricahua Community Health Centers, Inc. CurrentSince Dec 12, 2022 Accepting new patients

Locations

335 S Ocotillo St
Benson, AZ 85602
Phone (520) 326-4811

108 Arizona St
Bisbee, AZ 85603
Phone (520) 432-3309

1205 N F Ave
Douglas, AZ 85607
Phone (520) 364-6852

10566 N Highway 191
Elfrida, AZ 85610
Phone (520) 642-2222

77 Calle Portal
Ste C240
Sierra Vista, AZ 85635
Phone (520) 335-6271

77 Calle Portal
Ste A140
Sierra Vista, AZ 85635
Phone (520) 515-8669

155 Calle Portal
Ste 300
Sierra Vista, AZ 85635
Phone (520) 458-6331

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1003465600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 W WILSON ST APT C",
            "city": "BATAVIA",
            "state": "IL",
            "postal_code": "605101884",
            "telephone_number": "630-770-6841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 CALLE PORTAL STE C240",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352986",
            "telephone_number": "520-515-8669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 E Main St",
            "address_purpose": "LOCATION",
            "city": "St Charles",
            "state": "IL",
            "postal_code": "601741948",
            "country_code": "US",
            "telephone_number": "630-587-3777",
            "fax_number": "630-587-3791",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'TOOLE",
        "first_name": "CHRISTINE",
        "middle_name": "ANNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-05",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.021531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Vista, AZ

Sources for this page

Verify at the official NPI Registry.