Individual provider Active NPI

Keara Lee O'Bryen, LMSW

  • Social Worker
  • Dix Hills, NY
National Provider Identifier
1538918826
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
117291 Issued in NY
Practice address
151 Burrs LN
Dix Hills, NY 11746-6052
Phone
(516) 518-0784
NPI assigned
May 17, 2024
Last updated
May 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 117291 NY Primary

Addresses

Primary practice location

151 Burrs LN
Dix Hills, NY 11746-6052

Mailing address

66 Christmas St
North Babylon, NY 11703-5304
Phone (631) 219-0681

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
117291NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1715904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1538918826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 CHRISTMAS ST",
            "city": "NORTH BABYLON",
            "state": "NY",
            "postal_code": "117035304",
            "telephone_number": "631-219-0681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 BURRS LN",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117466052",
            "telephone_number": "516-518-0784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRYEN",
        "first_name": "KEARA",
        "middle_name": "LEE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-17",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "117291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dix Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; 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.