| Kelly Obrien Licensed Clinical Social Worker | |
|
365 Summerhaven Dr N East Syracuse NY 13057-3130 | |
| (315) 325-8619 | |
| Not Available |
| Full Name | Kelly Obrien Licensed Clinical Social Worker |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 365 Summerhaven Dr N, East Syracuse, New York |
| Authorized Official Name and Position | Kelly Theresa O'brien (SOLE MBR) |
| Authorized Official Contact | 3153258619 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly Obrien Licensed Clinical Social Worker 365 Summerhaven Dr N East Syracuse NY 13057-3130 Ph: (315) 325-8619 | Kelly Obrien Licensed Clinical Social Worker 365 Summerhaven Dr N East Syracuse NY 13057-3130 Ph: (315) 325-8619 |
| NPI Number | 1780448183 |
|---|---|
| Provider Enumeration Date | 02/07/2024 |
| Last Update Date | 02/07/2024 |
| Certification Date | 02/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780448183 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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