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NPI Code Detail

MEDICARE: ANDREW O'BRIEN LMSW

MEDICARE:   ANDREW  O'BRIEN  LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker6801114407MI

General Provider Information

NPI Number : 1336887223
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW O'BRIEN LMSW
Provider Business Mailing Address
First Line : 526 W 14TH ST # 132
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49684-4051
Country : US
Telephone Number : 231-538-2046
Fax Number :
Provider Business Practice Location Address
First Line : 526 W 14TH ST # 132
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49684-4051
Country : US
Telephone Number : 231-538-2046
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2022
Last Update Date : 06/03/2022

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Directions to “ ANDREW O'BRIEN LMSW” Practice Location

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