Individual
SHANNON G O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW, CSAC,CTS
Contact information
Practice address
2821 N. 4TH STREET, SUITE 139, MILWAUKEE, WI 53212
(414) 264-4217
(414) 264-4218
Mailing address
2821 N 4TH ST, SUITE 139, MILWAUKEE, WI 53212-2362
(414) 264-4217
(414) 264-4218
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1971-132
WI
1041C0700X
Clinical Social Worker
Primary
7197-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39397100
—
WI
Enumeration date
11/01/2006
Last updated
03/07/2011
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