Individual provider Active NPI

Eleanor Elizabeth O'Neil, LICSW

  • Clinical Social Worker
  • Woodbury, MN
National Provider Identifier
1891572921
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
25013 Issued in MN
Practice address
2040 Woodwinds Dr
Woodbury, MN 55125-2522
Phone
(651) 259-9750
NPI assigned
Sep 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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 25013 MN Primary

Addresses

Primary practice location

2040 Woodwinds Dr
Woodbury, MN 55125-2522

Mailing address

2040 Woodwinds Dr
Woodbury, MN 55125-2522
Phone (651) 259-9750

Other names 1

  • Eleanor Elizabeth Nwanokwale Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20231121001621 MN Practitioner - Clinical Social Worker 5193173748

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25013MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aris Behavioral Health LLC CurrentSince Sep 17, 2023 Accepting new patients

Locations

2040 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 259-9750

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": "1694476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1891572921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 WOODWINDS DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252522",
            "telephone_number": "651-259-9750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 WOODWINDS DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252522",
            "telephone_number": "651-259-9750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEIL",
        "first_name": "ELEANOR",
        "middle_name": "ELIZABETH",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-12",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "25013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELEANOR",
            "last_name": "NWANOKWALE",
            "middle_name": "ELIZABETH",
            "credential": "LICSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.