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General NPI Number Information
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NPI Number | 1083767404
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Entity Type | Individual
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Provider Name | MARY R O'BEIRNE MA, LMHC
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Gender | Female
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 301 BROADWAY
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City | CHELSEA
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State | MA
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Zip | 02150-2807
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Country | US
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Telephone | 617-912-7996
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Fax |
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Provider Business Mailing Address
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Address Line | 48 LAKE AVE N.E#7
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City | WOBURN
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State | MA
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Zip | 01801-6042
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Country | US
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Telephone | 781-933-0108
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LMHC954
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License Number State | MA
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