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NPI Code Detail

MEDICARE: MR. STEPHEN J O'BRIEN LCSW-R

MEDICARE:  MR. STEPHEN J O'BRIEN  LCSW-R
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251300000XLocal Education Agency (LEA)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154605913
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. STEPHEN J O'BRIEN LCSW-R
Provider Business Mailing Address
First Line : 428 RICHMOND AVE APT 1
Second Line :
City : BUFFALO
State : NY
Zip : 14222-1741
Country : US
Telephone Number : 167-397-1644
Fax Number :
Provider Business Practice Location Address
First Line : 428 RICHMOND AVE APT 1
Second Line :
City : BUFFALO
State : NY
Zip : 14222-1741
Country : US
Telephone Number : 163-971-6447
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2011
Last Update Date : 04/05/2019

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Directions to “ MR. STEPHEN J O'BRIEN LCSW-R” Practice Location

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