Obrien, Kimberly

Obrien, Kimberly is an individual health care provider with primary practice located at 12 Red Gate Rd , Walpole MA 02081-3785. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Obrien, Kimberly can be contacted via phone (781) 696-6779.

Contact Information

Primary practice address
12 Red Gate Rd Walpole MA 02081-3785
Phone: (781) 696-6779
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 114403 Massachusetts
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1275694309
LBN Legal business name Obrien, Kimberly
Credentials PHD, LICSW
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2006
Last updated Feb 15th, 2024 - about 9 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275694309 NPPES
Massachusetts Other 042611055 TAX ID
Massachusetts Other 703136 TAX ID
Massachusetts Other M18633 TAX ID
Massachusetts Other NP01332 TAX ID
Massachusetts Other 1004745 TAX ID
Massachusetts Other 1303287 TAX ID
Massachusetts MEDICAID 1303287 TAX ID

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