MEDICARE: CASSANDRA LYNN O'BRIEN LPC-ASSOCIATE

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
1	101YP2500X	Professional Counselor	102558	TX
2	101YM0800X	Mental Health Counselor	102558	TX

General Provider Information

NPI Number	:	1467384024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASSANDRA LYNN O'BRIEN LPC-ASSOCIATE

Provider Business Mailing Address
First Line	:	4245 KEMP BLVD STE 506
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76308-2822
Country	:	US
Telephone Number	:	940-247-7276
Fax Number	:	940-241-0888

Provider Business Practice Location Address
First Line	:	4245 KEMP BLVD STE 506
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76308-2822
Country	:	US
Telephone Number	:	940-247-7276
Fax Number	:	940-241-0888

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2026
Last Update Date	:	05/29/2026

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