Provider Demographics
NPI:1346494069
Name:ANNE ACKERMAN-O'BRIEN, LCSW LLC
Entity Type:Organization
Organization Name:ANNE ACKERMAN-O'BRIEN, LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ACKERMAN-O'BRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-255-2162
Mailing Address - Street 1:1207 LIGHTHOUSE LN
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-8159
Mailing Address - Country:US
Mailing Address - Phone:732-255-2162
Mailing Address - Fax:
Practice Address - Street 1:801 MAIN ST
Practice Address - Street 2:SUITE 1A
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-6697
Practice Address - Country:US
Practice Address - Phone:732-255-2162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-07
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05349500261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health