Healthcare Provider Details

I. General information

NPI: 1669146635
Provider Name (Legal Business Name): OBRIEN WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2021
Last Update Date: 07/19/2024
Certification Date: 07/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 MASSACHUSETTS AVE
ARLINGTON MA
02474-6700
US

IV. Provider business mailing address

17 FLORENCE AVE
ARLINGTON MA
02476-5909
US

V. Phone/Fax

Practice location:
  • Phone: 585-200-7712
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MARGARET OBRIEN
Title or Position: OWNER/CLINICIAN
Credential: LMHC
Phone: 857-206-6004