Provider Demographics
NPI:1316671738
Name:O'BRIEN, JESSICA LYNN
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYNN
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:LYNN
Other - Last Name:HARBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23101 E 26TH RD
Mailing Address - Street 2:
Mailing Address - City:ROSAMOND
Mailing Address - State:IL
Mailing Address - Zip Code:62083-2013
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:23101 E 26TH RD
Practice Address - Street 2:
Practice Address - City:ROSAMOND
Practice Address - State:IL
Practice Address - Zip Code:62083-2013
Practice Address - Country:US
Practice Address - Phone:217-825-3165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst