Provider Demographics
NPI:1528365475
Name:O'BRIEN, THOMAS FRANCIS (PHD, AND EDD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:FRANCIS
Last Name:O'BRIEN
Suffix:
Gender:M
Credentials:PHD, AND EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 FOUR FALLS CORPORATE CTR
Mailing Address - Street 2:SUITE 312
Mailing Address - City:WEST CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-2950
Mailing Address - Country:US
Mailing Address - Phone:610-397-0950
Mailing Address - Fax:
Practice Address - Street 1:100 FOUR FALLS CORPORATE CTR
Practice Address - Street 2:SUITE 312
Practice Address - City:WEST CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-2950
Practice Address - Country:US
Practice Address - Phone:610-397-0950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-11
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC001678101YP2500X
NJ37PC00109600101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional