Healthcare Provider Details

I. General information

NPI: 1710322565
Provider Name (Legal Business Name): DAVID H O'BRIEN LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2013
Last Update Date: 09/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 SPRINGDALE DRIVE - SUITE 100 HEALTH ADVOCATE EMPLOYEE ASSISTANCE PROGRAM
EXTON PA
19341
US

IV. Provider business mailing address

835 SPRINGDALE DR STE 100
EXTON PA
19341-2841
US

V. Phone/Fax

Practice location:
  • Phone: 484-885-2642
  • Fax: 610-644-1134
Mailing address:
  • Phone: 484-885-2642
  • Fax: 610-644-1134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC006914
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierPC006914
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerPROFESSIONAL COUNSELOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: