Provider Demographics
NPI:1407283567
Name:OBRIEN, LAURA M (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:M
Last Name:OBRIEN
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-5000
Mailing Address - Country:US
Mailing Address - Phone:845-323-4928
Mailing Address - Fax:
Practice Address - Street 1:132 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-5000
Practice Address - Country:US
Practice Address - Phone:845-323-4928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR048984-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical