Provider Demographics
NPI:1972745339
Name:O'BRIEN, SHARON (LPC)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13366
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-0366
Mailing Address - Country:US
Mailing Address - Phone:503-799-2668
Mailing Address - Fax:
Practice Address - Street 1:405 NW 18TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-2217
Practice Address - Country:US
Practice Address - Phone:503-799-2668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-01
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC2164101YM0800X
WALH00008898101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health