Provider Demographics
NPI:1730598608
Name:O'BRIEN, KATHARINE (MA, LCPC)
Entity type:Individual
Prefix:
First Name:KATHARINE
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:KATHARINE
Other - Middle Name:
Other - Last Name:SANDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:316 N 9TH ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:IL
Mailing Address - Zip Code:62301-2742
Mailing Address - Country:US
Mailing Address - Phone:217-222-8254
Mailing Address - Fax:217-222-4512
Practice Address - Street 1:316 N 9TH ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:IL
Practice Address - Zip Code:62301-2742
Practice Address - Country:US
Practice Address - Phone:217-222-8254
Practice Address - Fax:217-222-4512
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-05
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.010044101Y00000X
IL180.010113101YP2500X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor