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Individual

CARLY OBRIEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
436 MONARCH DR, YORK, PA 17403-9004
(732) 236-1901
Mailing address
436 MONARCH DR, YORK, PA 17403-9004
(732) 236-1901

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
081371
NY
1041C0700X
Clinical Social Worker
Primary
44SC05747800
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
081371
LICENSED CLINICAL SOCIAL WORKER
NY
01
44SC05747800
LICENSED CLINICAL SOCIAL WORKER
NJ
Enumeration date
01/11/2021
Last updated
01/11/2021
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