Provider Demographics
NPI:1962486746
Name:OBRIEN, MAUREEN CATHERINE (MSW)
Entity type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:CATHERINE
Last Name:OBRIEN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 WOODS RD
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:CT
Mailing Address - Zip Code:06524-3103
Mailing Address - Country:US
Mailing Address - Phone:203-393-2280
Mailing Address - Fax:203-393-2241
Practice Address - Street 1:969 W MAIN ST
Practice Address - Street 2:#2D
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-2653
Practice Address - Country:US
Practice Address - Phone:203-573-8555
Practice Address - Fax:203-597-9565
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0025181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical