Provider Demographics
NPI:1225365398
Name:O'BRIEN, COLLEEN LEE (LMSW)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:LEE
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1606 S HURON ST STE 972808
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-9998
Mailing Address - Country:US
Mailing Address - Phone:734-579-8193
Mailing Address - Fax:
Practice Address - Street 1:1606 S HURON ST STE 972808
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-9998
Practice Address - Country:US
Practice Address - Phone:734-579-8193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-11
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010882991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical