Individual provider Active NPI

Gene M O'Neill, MSW

  • Clinical Social Worker
  • Longview, WA
National Provider Identifier
1659487726
Registry record updated Nov 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW00005915 Issued in WA
Practice address
1230 7TH Ave
Longview, WA 98632-3166
Phone
(360) 575-4801
NPI assigned
Aug 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X OR2559 OR
Clinical Social Worker 1041C0700X LW00005915 WA Primary

Addresses

Primary practice location

1230 7TH Ave
Longview, WA 98632-3166

Mailing address

4454 Sunset Way
Longview, WA 98632-9583
Phone (360) 577-4563

Other practice location 1

3400 Main St
Vancouver, WA 98663-2223
Phone (360) 696-5300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20070822000102 WA Practitioner - Clinical Social Worker 9234221342 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OR2559ORMDClinical Social Worker
LW00005915WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Oct 18, 2022 Accepting new patients

Locations

400 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2000

8716 E Mill Plain Blvd
Vancouver, WA 98664
Phone (360) 514-4325

3400 Main St
Vancouver, WA 98663
Phone (360) 696-5016

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668297600000",
    "number": "1659487726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4454 SUNSET WAY",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986329583",
            "telephone_number": "360-577-4563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 7TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323166",
            "telephone_number": "360-575-4801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 Main St",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986632223",
            "country_code": "US",
            "telephone_number": "360-696-5300",
            "fax_number": "360-729-3372",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'NEILL",
        "first_name": "GENE",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2022-11-13",
        "certification_date": "2022-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "OR2559",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00005915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

Verify at the official NPI Registry.