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Individual

SHANNON G O'BRIEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW, LCSW, CSAC,CTS

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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