Provider Demographics
NPI:1306724067
Name:O'BRIEN, CYNTHIA ROSEMARY (LAC)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ROSEMARY
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 W CHICAGO CT
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-5249
Mailing Address - Country:US
Mailing Address - Phone:480-234-4880
Mailing Address - Fax:
Practice Address - Street 1:1016 W CHICAGO CT
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-5249
Practice Address - Country:US
Practice Address - Phone:480-234-4880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-21
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-23356101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health