Provider Demographics
NPI:1154651206
Name:OBREITER, MICHAEL T (LCAS)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:T
Last Name:OBREITER
Suffix:
Gender:M
Credentials:LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 N PINELLAS AVE
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-5780
Mailing Address - Country:US
Mailing Address - Phone:727-547-5200
Mailing Address - Fax:727-940-6073
Practice Address - Street 1:1919 N PINELLAS AVE
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-5780
Practice Address - Country:US
Practice Address - Phone:277-547-5200
Practice Address - Fax:727-940-6073
Is Sole Proprietor?:No
Enumeration Date:2010-01-12
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMCAP101YA0400X
NC1560101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)