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General NPI Number Information
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NPI Number | 1043232440
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Entity Type | Individual
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Provider Name | GUY JOSEPH MAHONEY PH.D., LCSW, BCD
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Gender | Male
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Dates
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Enumeration Date | 07/24/2006
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Last Update Date | 04/11/2008
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Provider Practice Location Address
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Address Line | 5113 LEESBURG PIKE SUITE 901
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City | FALLS CHURCH
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State | VA
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Zip | 22041-3257
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Country | US
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Telephone | 703-578-8539
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Fax |
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Provider Business Mailing Address
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Address Line | 2908 MEMORY LN
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City | SILVER SPRING
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State | MD
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Zip | 20904-6855
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 19259
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License Number State | TX
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