Provider Demographics
NPI:1720001712
Name:O'BRIEN, CAROLYN LOUISE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:LOUISE
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5901 AIRPORT BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-3156
Mailing Address - Country:US
Mailing Address - Phone:251-343-2597
Mailing Address - Fax:251-342-0122
Practice Address - Street 1:5901 AIRPORT BLVD STE B
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-3156
Practice Address - Country:US
Practice Address - Phone:251-343-2597
Practice Address - Fax:251-342-0122
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1338103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL11683296OtherCAQH
AL248726OtherCOMPSYCH
AL51538609OtherAMERICAN BEHAVIORAL -ABBM
AL515-28620OtherBCBS
ALOBRIE0002OtherDDS
AL11683296OtherCAQH