Healthcare Provider Details

I. General information

NPI: 1336407873
Provider Name (Legal Business Name): LAUREN KATHLEEN O'BRIEN LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2012
Last Update Date: 02/10/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16600 W SPRAGUE RD SUITE 90
MIDDLEBURG HEIGHTS OH
44130-6318
US

IV. Provider business mailing address

16600 W SPRAGUE RD SUITE 90
MIDDLEBURG HEIGHTS OH
44130-6318
US

V. Phone/Fax

Practice location:
  • Phone: 440-941-0425
  • Fax:
Mailing address:
  • Phone: 216-644-9534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.1400010-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: