Provider Demographics
NPI:1871668178
Name:O'BRIEN, DEBORAH HARRISON (MSW LICSW)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:HARRISON
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:MSW LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE HOSIPTAL COURT
Mailing Address - Street 2:SUITE 410
Mailing Address - City:BELLOWS FALLS
Mailing Address - State:VT
Mailing Address - Zip Code:05101
Mailing Address - Country:US
Mailing Address - Phone:802-463-3947
Mailing Address - Fax:802-463-1206
Practice Address - Street 1:107 PARK STREET
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VT
Practice Address - Zip Code:05156
Practice Address - Country:US
Practice Address - Phone:802-885-5171
Practice Address - Fax:802-885-4857
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT08900007281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1008598Medicaid