Sara M O'Brien, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

575 N Kellogg St
Suite 4
Galesburg, IL 61401-7608

Phone

(309) 343-0800

Fax

(309) 343-0802

NPI assigned

Nov 3, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Sara M Stasik Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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.

• Crossroads Counseling and Life Coaching LLC

  • Professional Counselor
  • Galesburg, IL
  • NPI 1255593315
  NPD (past)

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

{
    "created_epoch": "1478131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478131200000",
    "number": "1922550185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 N KELLOGG ST",
            "address_2": "SUITE 4",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614017608",
            "telephone_number": "309-343-0800",
            "fax_number": "309-343-0802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 N KELLOGG ST",
            "address_2": "SUITE 4",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614017608",
            "telephone_number": "309-343-0800",
            "fax_number": "309-343-0802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "SARA",
        "middle_name": "M",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-03",
        "last_updated": "2016-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "STASIK",
            "middle_name": "M",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• James Nesselroad
• New Century Physicians of Western Illinois, Inc
• Amy P Nielsen
• Erin R Noon
• Evelyn Margaret Nord-England, DMD
• Sara M Oakland, QMHP
• Cynthia Dawn Oberholtzer, APN
• Felipe Matthew Ocampo III
• Temisan Oki-Oduntan, WHNP
• Virginia Olin-Clay

• Psychologist in Galesburg, IL
• Providers in Galesburg, IL by specialty
• Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.

Verify at the official NPI Registry.