Amy Lynn O'Brien, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9695-123 Issued in WI

Practice address

314 N Main St
Oregon, WI 53575-1426

Phone

(608) 212-2766

NPI assigned

Sep 8, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Holding Space Psychotherapy

  • Community/Behavioral Health Agency
  • Oregon, WI
  • NPI 1689454100
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1694131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1114704780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 N MAIN ST",
            "city": "OREGON",
            "state": "WI",
            "postal_code": "535751426",
            "telephone_number": "608-212-2766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 N MAIN ST",
            "city": "OREGON",
            "state": "WI",
            "postal_code": "535751426",
            "telephone_number": "608-212-2766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-08",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9695-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joe Musacchio, LCSW
• Neeny Holdings, Inc.
• Catherine J Nelson, NP
• Mark Alan Nelson, DDS
• Michael David Nelson, DDS
• Kelsey Offerman
• David J Okada, MD
• Erin J Olheiser
• Melissa Olsen, MFT-IT
• Richard Dewey Olson, O.D.

• Clinical Social Worker in Oregon, WI
• Providers in Oregon, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.