Healthcare Provider Details

I. General information

NPI: 1215728191
Provider Name (Legal Business Name): LAUREN MARIE O'REILLY PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN MARIE BRAMSON

II. Dates (important events)

Enumeration Date: 05/13/2025
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 WISHARD BLVD
INDIANAPOLIS IN
46202-4163
US

IV. Provider business mailing address

71 GLASGOW LN
NOBLESVILLE IN
46060-5439
US

V. Phone/Fax

Practice location:
  • Phone: 317-944-8162
  • Fax:
Mailing address:
  • Phone: 630-930-9549
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number20043829A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number20043829B
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: