| Doctor Name: | MR. KEVIN OBRIEN |
| NPI Number: | 1275916645 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | 44SC05271000 |
| Business Practice Address: | 21 W Grochowiak St South River, NJ - 088821539 |
| Business Phone Number: | 7322571633 |
| Business Fax Number: | |
| Mailing Address: | 21 W Grochowiak St, SOUTH RIVER |
| State: | NJ |
| Postal Code: | 088821539 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 07/03/2015 |
| NPI Last Update Date: | 07/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 44SC05271000 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |