Provider Demographics
NPI:1740755495
Name:OBRIEN, PAUL FRANCIS (MSW)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:FRANCIS
Last Name:OBRIEN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 STRATTON RD
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-4621
Mailing Address - Country:US
Mailing Address - Phone:802-773-3386
Mailing Address - Fax:
Practice Address - Street 1:71 ALLEN ST
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-4570
Practice Address - Country:US
Practice Address - Phone:802-773-3386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-09
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT097.0134341OtherSTATE OF VERMONT NON LICENSED AND CERTIFIED PSYCHOTHERAPIST