Provider Demographics
NPI:1891860359
Name:O'BRIEN, BARBARA ELLEN (MED, LICSW,LAC,LPC)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:ELLEN
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:MED, LICSW,LAC,LPC
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:ELLEN
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, LICSW,LAC,LPC
Mailing Address - Street 1:7213 FORESTVIEW LN N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-5501
Mailing Address - Country:US
Mailing Address - Phone:763-201-1440
Mailing Address - Fax:763-201-1439
Practice Address - Street 1:7213 FORESTVIEW LN N
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-5501
Practice Address - Country:US
Practice Address - Phone:763-201-1440
Practice Address - Fax:763-201-1439
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1227101YA0400X
ND410-9-1-98101YP2500X
MN120101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN6248627OtherUNITED BEHAVIORAL HEALTH
MN068H5CEOtherBLUE CROSS BLUE SHIELD
MN6248627OtherMEDICA