Provider Demographics
NPI:1598392250
Name:O'BRIEN, MORGAN (MS, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:MS, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 DENNIS DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2988
Mailing Address - Country:US
Mailing Address - Phone:859-559-6041
Mailing Address - Fax:
Practice Address - Street 1:112 DENNIS DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2988
Practice Address - Country:US
Practice Address - Phone:859-559-6041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-24
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY262788103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst