MEDICARE: MR. ANDREW S MAHONEY M.S.,L.P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	PC003738	PA

General Provider Information

NPI Number	:	1922144369
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANDREW S MAHONEY M.S.,L.P.C.

Provider Business Mailing Address
First Line	:	5829 ELLSWORTH AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15232-1728
Country	:	US
Telephone Number	:	412-362-2639
Fax Number	:

Provider Business Practice Location Address
First Line	:	5829 ELLSWORTH AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15232-1728
Country	:	US
Telephone Number	:	412-362-2639
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	07/08/2007

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