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General NPI Number Information
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NPI Number | 1710875927
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Entity Type | Individual
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Provider Name | MICHAEL C O'BRIEN
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Gender | Male
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Dates
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Enumeration Date | 06/26/2025
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 4949 WESTOWN PKWY STE 100
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City | WEST DES MOINES
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State | IA
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Zip | 50266-6704
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Country | US
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Telephone | 515-344-2060
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Fax |
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Provider Business Mailing Address
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Address Line | 15490 BOSTON PKWY APT 111
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City | CLIVE
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State | IA
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Zip | 50325-4708
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Country | US
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Telephone | 815-582-9979
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 1101766
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License Number State | IA
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