Provider Demographics
NPI:1720143126
Name:O'BRIEN, KATE (MS, MSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:KATE
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:MS, MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5010 47TH AVENUE SOUTH
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-2035
Mailing Address - Country:US
Mailing Address - Phone:206-235-1768
Mailing Address - Fax:206-721-1768
Practice Address - Street 1:511 28TH AVENUE EAST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112
Practice Address - Country:US
Practice Address - Phone:206-235-1768
Practice Address - Fax:206-721-1768
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000054741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ094124OtherHEALTHCARECOSTCONTAINMENT