Provider Demographics
NPI:1689019168
Name:O'BRIEN, ADAM (LMHC CASAC)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:M
Credentials:LMHC CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 LOOMIS RD
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12037-9790
Mailing Address - Country:US
Mailing Address - Phone:518-573-2925
Mailing Address - Fax:
Practice Address - Street 1:160 LOOMIS RD
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:NY
Practice Address - Zip Code:12037-9790
Practice Address - Country:US
Practice Address - Phone:518-573-2925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-09
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6448101YM0800X
NY29103101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)