Provider Demographics
NPI:1326349515
Name:O'BRIEN, JILL KATHLEEN (LICSW)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:KATHLEEN
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:KATHLEEN
Other - Last Name:DULMAINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:37 TANANGER RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-2656
Mailing Address - Country:US
Mailing Address - Phone:085-776-8549
Mailing Address - Fax:
Practice Address - Street 1:311 SERVICE RD
Practice Address - Street 2:SPAULDING REHAB HOSPITAL CAPE COD
Practice Address - City:E. SANDWICH
Practice Address - State:MA
Practice Address - Zip Code:02537
Practice Address - Country:US
Practice Address - Phone:508-833-4125
Practice Address - Fax:508-833-4203
Is Sole Proprietor?:No
Enumeration Date:2010-11-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1176411041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical