Healthcare Provider Details

I. General information

NPI: 1942787080
Provider Name (Legal Business Name): NATALIE O'BRIEN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NATALIE MARYNCZAK LMSW, LCSW

II. Dates (important events)

Enumeration Date: 07/22/2018
Last Update Date: 03/06/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 CEDAR ST
NEW BRITAIN CT
06052-1301
US

IV. Provider business mailing address

204 ROUND HILL RD
MIDDLETOWN CT
06457-6118
US

V. Phone/Fax

Practice location:
  • Phone: 860-224-5900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number013189
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: