Provider Demographics
NPI:1568159671
Name:O'BRIEN, CHRISTINA DANIELLE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:DANIELLE
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:317 ROBINSON ST
Mailing Address - Street 2:
Mailing Address - City:COCHRANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19330-9409
Mailing Address - Country:US
Mailing Address - Phone:610-701-1107
Mailing Address - Fax:
Practice Address - Street 1:397 EAGLEVIEW BLVD STE 120
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-1150
Practice Address - Country:US
Practice Address - Phone:610-422-3064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-19
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
11583225A00000X
PAPC014504101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist