Active NPI
Carol Marie Obrien, PH.D.
- Clinical Psychologist
- Largo, FL
National Provider Identifier
1619081841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY5151
- Practice address
- 10823 Seminole Blvd
Suite 3a
Largo, FL 33778-3347 - Phone
- (727) 631-2679
- NPI assigned
- Aug 17, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY5151 | FL | Primary |
Addresses
Primary practice location
10823 Seminole Blvd
Suite 3a
Largo, FL 33778-3347
Mailing address
11115 66TH Ter
Seminole, FL 33772-6241
Phone (727) 631-2679
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY5151 | FL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456790400000",
"number": "1619081841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11115 66TH TER",
"city": "SEMINOLE",
"state": "FL",
"postal_code": "337726241",
"telephone_number": "727-631-2679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10823 SEMINOLE BLVD",
"address_2": "SUITE 3A",
"city": "LARGO",
"state": "FL",
"postal_code": "337783347",
"telephone_number": "727-631-2679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBRIEN",
"first_name": "CAROL",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-17",
"last_updated": "2016-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY5151",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Largo, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.