Provider Demographics
NPI:1679558910
Name:PARKER-O'BRIEN, ELIZABETH JANE (MSW)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:JANE
Last Name:PARKER-O'BRIEN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7656 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-8140
Mailing Address - Country:US
Mailing Address - Phone:410-443-1039
Mailing Address - Fax:
Practice Address - Street 1:7656 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-8140
Practice Address - Country:US
Practice Address - Phone:410-443-1039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-09
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD131931041C0700X
VT089-00004011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPO6423OtherBLUE CROSS/BLUE SHIELD
MA1857282Medicaid
MA1857282Medicaid