Individual provider Active NPI

Kendra-Leigh O'Neil

  • Clinical Social Worker
  • Quincy, MA
National Provider Identifier
1487017034
Registry record updated Mar 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
115807 Issued in MA
Practice address
11 Riverbank Rd
Quincy, MA 02169-3326
Phone
(617) 773-0633
Fax
(617) 773-2233
NPI assigned
Mar 31, 2016
Last updated
Mar 31, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2016

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 115807 MA Primary

Addresses

Primary practice location

11 Riverbank Rd
Quincy, MA 02169-3326

Mailing address

PO Box 113
Whitman, MA 02382-0113
Phone (617) 773-0633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20160727003050 MA Practitioner - Clinical Social Worker 5597058537 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Troup Behavioral Health, LLC CurrentSince Apr 15, 2016 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1459382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459382400000",
    "number": "1487017034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 113",
            "city": "WHITMAN",
            "state": "MA",
            "postal_code": "023820113",
            "telephone_number": "617-773-0633",
            "fax_number": "617-773-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 RIVERBANK RD",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021693326",
            "telephone_number": "617-773-0633",
            "fax_number": "617-773-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEIL",
        "first_name": "KENDRA-LEIGH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-31",
        "last_updated": "2016-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "115807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.