Provider Demographics
NPI:1134741341
Name:OBRIEN, JANE ELIZABETH (LCDC)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:ELIZABETH
Last Name:OBRIEN
Suffix:
Gender:F
Credentials:LCDC
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 241
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-8135
Mailing Address - Country:US
Mailing Address - Phone:972-548-0209
Mailing Address - Fax:
Practice Address - Street 1:1505 HARROUN AVE STE F
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-3433
Practice Address - Country:US
Practice Address - Phone:972-548-0209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-11
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4060101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)