Provider Demographics
NPI:1528531449
Name:O'BRIEN-HARTE, MARY BERNADETTE (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:BERNADETTE
Last Name:O'BRIEN-HARTE
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 WARWICK RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02465-1724
Mailing Address - Country:US
Mailing Address - Phone:617-584-6912
Mailing Address - Fax:
Practice Address - Street 1:301 BROOK ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-4371
Practice Address - Country:US
Practice Address - Phone:508-782-7343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1015689104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker