Individual provider Active NPI

Sheila T Odonnell, LCSW

  • Clinical Social Worker
  • Syracuse, NY
National Provider Identifier
1992833123
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
09427201 Issued in NY
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

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 2

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230116000710 NY Practitioner - Clinical Social Worker 3173992534 Reassigns benefits to 1 organization

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
Nysarc Inc. Onondaga County ChapterGroup PAC ID 9537252184, 19 clinicians

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

LicenseStateTypeSpecialty
094272NYMDMental Health Counselor
09427201NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nysarc Inc. Onondaga County Chapter CurrentSince Oct 31, 2022 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.

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

Verify at the official NPI Registry.