Individual provider Active NPI

Kari Ciaciuch O'Neill, LICSW

  • Clinical Social Worker
  • Issaquah, WA
National Provider Identifier
1194063164
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW60313502 Issued in WA
Practice address
22526 SE 64TH PL
Suite 220
Issaquah, WA 98027-5368
Phone
(425) 786-8566
NPI assigned
Jan 24, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2013

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 LW60313502 WA Primary

Addresses

Primary practice location

22526 SE 64TH PL
Suite 220
Issaquah, WA 98027-5368

Mailing address

22526 SE 64TH PL
Suite 220
Issaquah, WA 98027-5368
Phone (425) 786-8566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2022 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LW60313502WAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1358985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358985600000",
    "number": "1194063164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22526 SE 64TH PL",
            "address_2": "SUITE 220",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980275368",
            "telephone_number": "425-786-8566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22526 SE 64TH PL",
            "address_2": "SUITE 220",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980275368",
            "telephone_number": "425-786-8566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEILL",
        "first_name": "KARI",
        "middle_name": "CIACIUCH",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-24",
        "last_updated": "2013-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60313502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

Verify at the official NPI Registry.