Healthcare Provider Details

I. General information

NPI: 1548817281
Provider Name (Legal Business Name): MARGARET O'BRIEN LCAT, LMHC, BC-DMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2019
Last Update Date: 08/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 W 29TH ST RM 1104
NEW YORK NY
10001-5224
US

IV. Provider business mailing address

123 W 80TH ST
NEW YORK NY
10024-7137
US

V. Phone/Fax

Practice location:
  • Phone: 917-861-1330
  • Fax:
Mailing address:
  • Phone: 917-861-1330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225600000X
TaxonomyDance Therapist
License Number000613-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number002733-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: