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NPI Code Detail

MEDICARE: MR. PATRICK JOHN OBRIEN LCSW CAP

MEDICARE: MR. PATRICK JOHN OBRIEN LCSW CAP
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
1101YA0400XAddiction (Substance Use Disorder) Counselor4031CAPFL
21041C0700XClinical Social WorkerLCSW3051HI
31041C0700XClinical Social Worker5815SC
41041C0700XClinical Social Worker41718TX

General Provider Information

NPI Number : 1346292885
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PATRICK JOHN OBRIEN LCSW CAP
Provider Business Mailing Address
First Line : PO BOX 730726
Second Line :
City : ORMOND BEACH
State : FL
Zip : 32173-0726
Country : US
Telephone Number : 386-492-2845
Fax Number :
Provider Business Practice Location Address
First Line : 551 NATIONAL HEALTH CARE DR
Second Line :
City : DAYTONA BEACH
State : FL
Zip : 32114-1495
Country : US
Telephone Number : 386-323-7500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2006
Last Update Date : 10/18/2012

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