Latisha Ann O Neal, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.017689 Issued in IL

Practice address

102 W Kenwood Ave Ste 100
Decatur, IL 62526-4379

Phone

(217) 872-3800

Fax

(217) 872-0849

NPI assigned

Sep 20, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Clinical Social Worker

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Board of Trustees of Southern Illinois UniversityGroup PAC ID 4486667888, 139 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Board of Trustees of Southern Illinois University

  • Primary Care Clinic/Center
  • Springfield, IL
  • NPI 1396097960
  Medicare reassignment Care Compare group NPD
• Board of Trustees of Southern Illinois University

  • Federally Qualified Health Center (FQHC)
  • Carbondale, IL
  • NPI 1568210425
  NPD

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1770779969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19639",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949639",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W KENWOOD AVE STE 100",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264379",
            "telephone_number": "217-872-3800",
            "fax_number": "217-872-0849"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 W Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IL",
            "postal_code": "617012814",
            "country_code": "US",
            "telephone_number": "309-557-1400 x1469",
            "fax_number": "309-557-1461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O NEAL",
        "first_name": "LATISHA",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-20",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.017689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Marie Nowdomski, DMD
• Emily Ann Ntor-Ue, FNP
• Jacob Nuss
• Worlali Moses Nutakor, M.D.
• Monica L Nyman, MS RD LD IN
• Heather M O'Hara, M.D.
• Abdulbasit Oboh
• Debra Jeanne Oestreich, NP
• Martin Nnaemeka Okpalike, M.D.
• Felicia O Olawuni, MD

• Clinical Social Worker in Decatur, IL
• Providers in Decatur, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.