Provider Demographics
NPI:1407213424
Name:O'BRIEN, LOREEN (MA, MED, MDIV, CRC)
Entity Type:Individual
Prefix:
First Name:LOREEN
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:MA, MED, MDIV, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1936 BRUCE B DOWNS BLVD
Mailing Address - Street 2:#163
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-9262
Mailing Address - Country:US
Mailing Address - Phone:813-447-0338
Mailing Address - Fax:
Practice Address - Street 1:1936 BRUCE B DOWNS BLVD
Practice Address - Street 2:#163
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-9262
Practice Address - Country:US
Practice Address - Phone:813-447-0338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-21
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH13046101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health