Provider Demographics
NPI:1942787080
Name:O'BRIEN, NATALIE (LCSW)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:MARYNCZAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW, LCSW
Mailing Address - Street 1:204 ROUND HILL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-6118
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:73 CEDAR ST
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-1301
Practice Address - Country:US
Practice Address - Phone:860-224-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-22
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0131891041C0700X
CT104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker