Provider Demographics
NPI:1336230986
Name:O BRIEN, MAUREEN (MSSA LICSW)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:
Last Name:O BRIEN
Suffix:
Gender:F
Credentials:MSSA LICSW
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 125
Mailing Address - Street 2:
Mailing Address - City:FITZWILLIAM
Mailing Address - State:NH
Mailing Address - Zip Code:03447
Mailing Address - Country:US
Mailing Address - Phone:603-924-7462
Mailing Address - Fax:603-924-2138
Practice Address - Street 1:20 GROVE STREET
Practice Address - Street 2:PETERBOROUGH CLINICAL ASSOCIATES
Practice Address - City:PETERBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03458
Practice Address - Country:US
Practice Address - Phone:603-924-7462
Practice Address - Fax:603-924-2138
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2401041C0700X
MA10158611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH240OtherAETNA
P07848OtherBLUE CROSS MA
1039550OtherBEACON HEALTH
NH80001345Medicaid
NH240OtherNAHGA
006245OtherVALUE OPTIONS
NH240OtherC B A
NH240OtherHEALTH CARE VALUE MANAGEM
1402015Y0NH01OtherANTHEM
15398OtherCIGNA
NH240OtherBENEFIT PLAN
NH240OtherPBH
NH240OtherTRICARE
NH240OtherUBH
006245OtherVALUE OPTIONS