Provider Demographics
NPI:1821372442
Name:O'BRIEN, COURTNEY (PHD)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:SUSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:13 WOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-2438
Mailing Address - Country:US
Mailing Address - Phone:516-541-1928
Mailing Address - Fax:
Practice Address - Street 1:7901 BROADWAY FL 10
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1329
Practice Address - Country:US
Practice Address - Phone:718-334-1417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-30
Last Update Date:2018-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist