Individual provider Active NPI

Christine Marie O'Neill, LCSW

  • Social Worker
  • Staten Island, NY
National Provider Identifier
1366035669
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
091976 Issued in NY
Practice address
633 Clove Rd
Staten Island, NY 10310-2736
Phone
(347) 671-7270
NPI assigned
Feb 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 091976 NY Primary

Addresses

Primary practice location

633 Clove Rd
Staten Island, NY 10310-2736

Mailing address

436 Sheffield St
Staten Island, NY 10310-2051
Phone (646) 258-1767

Other practice location 1

153 New Dorp Ln
Staten Island, NY 10306-3050
Phone (347) 671-7270

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
091976NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1366035669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 SHEFFIELD ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103102051",
            "telephone_number": "646-258-1767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 CLOVE RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103102736",
            "telephone_number": "347-671-7270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "153 New Dorp Ln",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103063050",
            "country_code": "US",
            "telephone_number": "347-671-7270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'NEILL",
        "first_name": "CHRISTINE",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-17",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "091976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.