Provider Demographics
NPI:1568123404
Name:O'BRIEN, KATHY (T-LMHC , CADC)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:T-LMHC , CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9295 BISHOP DR STE 105
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-1649
Mailing Address - Country:US
Mailing Address - Phone:515-505-8313
Mailing Address - Fax:
Practice Address - Street 1:9295 BISHOP DR STE 105
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1649
Practice Address - Country:US
Practice Address - Phone:515-505-8313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-03
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA107066101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health