Provider Demographics
NPI:1144759614
Name:O'BRIEN, ELAINA MARIE (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:ELAINA
Middle Name:MARIE
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10912 CENTRAL PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-2240
Mailing Address - Country:US
Mailing Address - Phone:631-365-5119
Mailing Address - Fax:
Practice Address - Street 1:8022 OLD COUNTY ROAD 54
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-6409
Practice Address - Country:US
Practice Address - Phone:727-784-8244
Practice Address - Fax:727-264-8802
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW84281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical