Provider Demographics
NPI:1164799623
Name:O'BRIEN PSYCHOLOGICAL SERVICES, INC.
Entity Type:Organization
Organization Name:O'BRIEN PSYCHOLOGICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:X
Authorized Official - Last Name:O'BRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:317-258-5058
Mailing Address - Street 1:13200 DUNWOODY LN
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-8742
Mailing Address - Country:US
Mailing Address - Phone:317-258-5058
Mailing Address - Fax:317-575-6453
Practice Address - Street 1:5336 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46203-6023
Practice Address - Country:US
Practice Address - Phone:317-258-5058
Practice Address - Fax:317-575-6453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty