Active NPI
Sheila T Odonnell, LCSW
- Clinical Social Worker
- Syracuse, NY
National Provider Identifier
1992833123
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 09427201
- Practice address
- 600 S Wilbur Ave
Syracuse, NY 13204-2730 - Phone
- (315) 476-7441
- Fax
- (315) 476-7446
- NPI assigned
- Mar 1, 2007
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 094272 | NY | |
| Clinical Social Worker | 1041C0700X | 09427201 | NY | Primary |
Addresses
Primary practice location
600 S Wilbur Ave
Syracuse, NY 13204-2730
Mailing address
102 Southwest Way
Camillus, NY 13031-1209
Phone (315) 487-0086
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
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
600 S Wilbur Ave
Syracuse, NY 13204-2730
Phone (315) 476-7441
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 094272 | NY | MD | Mental Health Counselor |
| 09427201 | NY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nysarc Inc. Onondaga County Chapter | Current | Accepting new patients | |
| State of New York Comptrollers Office | Past | Accepting new patients |
Locations
600 S Wilbur Ave
Syracuse, NY 13204
Phone (315) 476-7441
Organizations & group practices 2
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.
-
- Developmental Disabilities Clinic/Center
- Syracuse, NY
- NPI 1043397490
-
- Developmental Disabilities Clinic/Center
- Staten Island, NY
- NPI 1750469912
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719878400000",
"number": "1992833123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 SOUTHWEST WAY",
"city": "CAMILLUS",
"state": "NY",
"postal_code": "130311209",
"telephone_number": "315-487-0086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 S WILBUR AVE",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132042730",
"telephone_number": "315-476-7441",
"fax_number": "315-476-7446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODONNELL",
"first_name": "SHEILA",
"middle_name": "T",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-01",
"last_updated": "2024-07-02",
"certification_date": "2024-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "094272",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "09427201",
"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 Jul 2, 2024; 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.