Provider Demographics
NPI:1952177784
Name:O'BRIEN, MICHAELA KATHLEEN (MS, PLMHP)
Entity Type:Individual
Prefix:MRS
First Name:MICHAELA
Middle Name:KATHLEEN
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:MS, PLMHP
Other - Prefix:MS
Other - First Name:MICHAELA
Other - Middle Name:KATHLEEN
Other - Last Name:WOLF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, PLMHP
Mailing Address - Street 1:2521 BROOKSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-1835
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9802 NICHOLAS ST STE 350
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-2106
Practice Address - Country:US
Practice Address - Phone:932-229-6402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13174101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health