Provider Demographics
NPI:1174651277
Name:O'BRIEN, DONNA (LMHC)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:BARRE
Mailing Address - State:MA
Mailing Address - Zip Code:01005-8839
Mailing Address - Country:US
Mailing Address - Phone:508-287-3415
Mailing Address - Fax:
Practice Address - Street 1:124 HARVARD ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-6478
Practice Address - Country:US
Practice Address - Phone:508-287-3415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3915101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA790763OtherTUFTS HEALTH PLAN
MALM0512OtherBLUE CROSS BLUE SHIELD OF