Provider Demographics
NPI:1104216969
Name:OBRIEN, DANIEL (LSW)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:OBRIEN
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16505 CHATFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-4261
Mailing Address - Country:US
Mailing Address - Phone:440-472-8437
Mailing Address - Fax:
Practice Address - Street 1:35645 STATE ROUTE 303
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:OH
Practice Address - Zip Code:44044-9660
Practice Address - Country:US
Practice Address - Phone:440-476-8627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-02
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical