Provider Demographics
NPI:1427580059
Name:OMOBIEN, ODIRI (MSSA,LISW-S)
Entity type:Individual
Prefix:
First Name:ODIRI
Middle Name:
Last Name:OMOBIEN
Suffix:
Gender:F
Credentials:MSSA,LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3231 EVANS WAY
Mailing Address - Street 2:
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-3291
Mailing Address - Country:US
Mailing Address - Phone:330-815-2825
Mailing Address - Fax:
Practice Address - Street 1:842 CORPORATE WAY STE 800
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-1569
Practice Address - Country:US
Practice Address - Phone:440-213-4530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-02
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.21030541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical