Provider Demographics
NPI:1336795145
Name:O'BRIEN, ELIZABETH SANCHEZ (LICSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:SANCHEZ
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 ASH ST
Mailing Address - Street 2:
Mailing Address - City:HOPKINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01748-1928
Mailing Address - Country:US
Mailing Address - Phone:617-872-0956
Mailing Address - Fax:
Practice Address - Street 1:6 CHURCH STREET
Practice Address - Street 2:THIRD FLOOR
Practice Address - City:HOPKINTON
Practice Address - State:MA
Practice Address - Zip Code:01748-1928
Practice Address - Country:US
Practice Address - Phone:508-377-3022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-16
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA111079101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA111079OtherPROFESSIONAL LICENSE