Provider Demographics
NPI:1487043063
Name:O'BRIEN, YVONNE PATRICIA (LMSW)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:PATRICIA
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 JEFFERSON RD UNIT 1-14
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-4130
Mailing Address - Country:US
Mailing Address - Phone:203-208-0495
Mailing Address - Fax:
Practice Address - Street 1:230 ASHMUN STREET
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511
Practice Address - Country:US
Practice Address - Phone:203-786-5970
Practice Address - Fax:203-777-5839
Is Sole Proprietor?:No
Enumeration Date:2015-01-20
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000045104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker