Healthcare Provider Details

I. General information

NPI: 1730006115
Provider Name (Legal Business Name): MELISSA ARLINE MAHONEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 NJ-24 STE 3
CHESTER NJ
07934
US

IV. Provider business mailing address

246 HOMESTEAD PL
PARK RIDGE NJ
07656-2434
US

V. Phone/Fax

Practice location:
  • Phone: 609-359-2266
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37AC00969800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: