Provider Demographics
NPI:1376796730
Name:O'BRIEN, IRENE M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:IRENE
Middle Name:M
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:IRENE
Other - Middle Name:T
Other - Last Name:MARMO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3074 WHITNEY AVE
Mailing Address - Street 2:MT CARMEL COUNSELING & PSYCHOTHERAPY 2ND FLOOR
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518
Mailing Address - Country:US
Mailing Address - Phone:203-248-5623
Mailing Address - Fax:203-248-5623
Practice Address - Street 1:3074 WHITNEY AVE
Practice Address - Street 2:MT CARMEL COUNSELING & PSYCHOTHERAPY 2ND FLOOR
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518
Practice Address - Country:US
Practice Address - Phone:203-248-5623
Practice Address - Fax:203-248-5623
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0019111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical