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General NPI Number Information
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NPI Number | 1518789544
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Entity Type | Individual
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Provider Name | TERYN JEAN O'BRIEN LMHC-A
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Gender | Female
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Dates
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Enumeration Date | 10/30/2024
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 65 VILLAGE SQUARE DR STE 302
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City | SOUTH KINGSTOWN
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State | RI
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Zip | 02879-2569
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Country | US
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Telephone | 401-785-0040
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Fax |
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Provider Business Mailing Address
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Address Line | 25 MANNING TER
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City | NEWPORT
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State | RI
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Zip | 02840-2341
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Country | US
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Telephone | 719-309-8377
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MHC00285-A
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License Number State | RI
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