Provider Demographics
NPI:1316205610
Name:O'BRIEN, JONI SINI (MLADC)
Entity Type:Individual
Prefix:
First Name:JONI
Middle Name:SINI
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:MLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 PARKER ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-4033
Mailing Address - Country:US
Mailing Address - Phone:978-225-2250
Mailing Address - Fax:
Practice Address - Street 1:35 CENTER STREET
Practice Address - Street 2:THE OFFICE #2
Practice Address - City:WOLFEBORO
Practice Address - State:NH
Practice Address - Zip Code:03896
Practice Address - Country:US
Practice Address - Phone:603-986-3796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-25
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0573101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3099796Medicaid