Provider Demographics
NPI:1336279355
Name:O'BRIEN, BRIGID D (LPCC/S)
Entity Type:Individual
Prefix:
First Name:BRIGID
Middle Name:D
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:LPCC/S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:547 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:OH
Mailing Address - Zip Code:44001-2237
Mailing Address - Country:US
Mailing Address - Phone:419-357-0369
Mailing Address - Fax:
Practice Address - Street 1:25000 CENTER RIDGE RD STE 6
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-4105
Practice Address - Country:US
Practice Address - Phone:440-892-7034
Practice Address - Fax:440-250-9013
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC0500626101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health