Provider Demographics
NPI:1770820714
Name:OBRIEN, SEAN J (LCSW)
Entity Type:Individual
Prefix:MR
First Name:SEAN
Middle Name:J
Last Name:OBRIEN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 LAWRENCE BROOK DR
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-1111
Mailing Address - Country:US
Mailing Address - Phone:732-501-5733
Mailing Address - Fax:
Practice Address - Street 1:19 LAWRENCE BROOK DR
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-1111
Practice Address - Country:US
Practice Address - Phone:732-501-5733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-10
Last Update Date:2017-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055300001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical