Active NPI
Kristin O'Kane, LMSW
- Psychologist
- Syracuse, NY
National Provider Identifier
1710369673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 023598-01
- Practice address
- 100 Intrepid LN Ste 2
Syracuse, NY 13205-2546 - Phone
- (315) 797-6241
- NPI assigned
- Jun 26, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 083994-1 | NY | |
| Psychologist | 103T00000X | 023598-01 | NY | Primary |
Addresses
Primary practice location
100 Intrepid LN Ste 2
Syracuse, NY 13205-2546
Mailing address
5365 Tourmaline Dr
Clay, NY 13041-8973
Phone (315) 725-1927
Other practice location 1
2608 Genesee St
Utica, NY 13502-6003
Phone (315) 797-6241
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 023598-01 | NY | MD | Psychologist |
| 083994-1 | NY | MD | Social Worker |
| 023598 | NY | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arise Child and Family Service Inc | Current | Accepting new patients | |
| Accesscny, Inc | Psychologist | Current | Accepting new patients |
| Central New York Quest, Inc. | Past | Accepting new patients | |
| Onondaga Pastoral Counseling Center | Past | Accepting new patients |
Locations
635 James St
Syracuse, NY 13203
Phone (315) 472-3171
1603 Court St
Syracuse, NY 13208
Phone (315) 455-7591
Interoperability endpoints
- kristin.okane.p1@direct.liberty-resources.nextgenshare.com
Organizations & group practices 4
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.
-
- Developmentally Disabled Services Day Training Agency
- Syracuse, NY
- NPI 1750381968
Psychologist
-
- Mental Health Counselor
- Syracuse, NY
- NPI 1336256213
-
- Clinical Psychologist
- New York Mills, NY
- NPI 1649540063
-
- Community/Behavioral Health Agency
- Syracuse, NY
- NPI 1518153477
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586217600000",
"number": "1710369673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5365 TOURMALINE DR",
"city": "CLAY",
"state": "NY",
"postal_code": "130418973",
"telephone_number": "315-725-1927"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 INTREPID LN STE 2",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132052546",
"telephone_number": "315-797-6241"
}
],
"practiceLocations": [
{
"address_1": "2608 Genesee St",
"address_purpose": "LOCATION",
"city": "Utica",
"state": "NY",
"postal_code": "135026003",
"country_code": "US",
"telephone_number": "315-797-6241",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "O'KANE",
"first_name": "KRISTIN",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-26",
"last_updated": "2020-04-07",
"certification_date": "2020-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "083994-1",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "023598-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.