Provider Demographics
NPI:1497067631
Name:O'BRIEN, LESLIE R (MSW, LICSW)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:R
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 PHILBRICK RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-6004
Mailing Address - Country:US
Mailing Address - Phone:617-232-4452
Mailing Address - Fax:
Practice Address - Street 1:34 PHILBRICK RD
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-6004
Practice Address - Country:US
Practice Address - Phone:617-232-4452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-03
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool