Provider Demographics
NPI:1154766806
Name:O'BRIEN, ARLENE J (LPC)
Entity type:Individual
Prefix:MRS
First Name:ARLENE
Middle Name:J
Last Name:O'BRIEN
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 111
Mailing Address - Street 2:15423 MCCLOY ROAD
Mailing Address - City:LICKING
Mailing Address - State:MO
Mailing Address - Zip Code:65542-0111
Mailing Address - Country:US
Mailing Address - Phone:417-260-7707
Mailing Address - Fax:
Practice Address - Street 1:15423 MCCLOY ROAD
Practice Address - Street 2:
Practice Address - City:LICKING
Practice Address - State:MO
Practice Address - Zip Code:65542
Practice Address - Country:US
Practice Address - Phone:417-260-7707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-08
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010040294101Y00000X, 101YA0400X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1154766806Medicaid