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General NPI Number Information
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NPI Number | 1245686468
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Entity Type | Individual
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Provider Name | JAMES J MAHONEY III PHD
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Gender | Male
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Dates
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Enumeration Date | 05/06/2016
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 1300 JEFFERSON PARK AVE
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-3363
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Country | US
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Telephone | 434-924-2718
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 749112
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City | ATLANTA
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State | GA
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Zip | 30374-9112
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Country | US
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Telephone | 434-295-1000
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 1146
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810005380
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 0810005380
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License Number State | VA
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