Provider Demographics
NPI:1205258563
Name:O'BRIAN, SHERRY L (LCSW)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:L
Last Name:O'BRIAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 METSKER LN
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46062-8921
Mailing Address - Country:US
Mailing Address - Phone:317-470-2328
Mailing Address - Fax:
Practice Address - Street 1:33 METSKER LN
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46062-8921
Practice Address - Country:US
Practice Address - Phone:317-470-2328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-06
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34003865A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical