Individual
KEVIN P O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, LMFT
Contact information
Practice address
620 S 76TH ST, MILWAUKEE, WI 53214-1599
(414) 453-1400
(414) 453-2538
Mailing address
9000 W WISCONSIN AVE # MS 958, MILWAUKEE, WI 53226-4874
(414) 266-7615
(414) 266-6238
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
162
WI
106H00000X
Marriage & Family Therapist
691
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063429520
—
WI
Enumeration date
08/01/2006
Last updated
03/13/2020
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