Provider Demographics
NPI:1073632485
Name:ONEIL, CHRISTINA M (LCSWR)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:M
Last Name:ONEIL
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:MISS
Other - First Name:CHRISTINA
Other - Middle Name:M
Other - Last Name:LUMBIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSW
Mailing Address - Street 1:218 STONE ST FL 2
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-3211
Mailing Address - Country:US
Mailing Address - Phone:315-782-7445
Mailing Address - Fax:
Practice Address - Street 1:218 STONE ST FL 2
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-3211
Practice Address - Country:US
Practice Address - Phone:315-782-7445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR052073104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBB1741Medicare PIN