Individual provider Active NPI

Kristin O'Kane, LMSW

  • Psychologist
  • Syracuse, NY
National Provider Identifier
1710369673
Registry record updated Apr 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
023598-01 Issued in NY
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

Updated by the provider on Apr 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200826002843 NY Practitioner - Clinical Psychologist 1951728682 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
023598-01NYMDPsychologist
083994-1NYMDSocial Worker
023598NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Arise Child and Family Service Inc CurrentSince Jul 10, 2020 Accepting new patients
Accesscny, Inc Psychologist CurrentSince May 30, 2025 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.