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General NPI Number Information
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NPI Number | 1265860118
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Entity Type | Organization
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Legal Business Name | MEGAN MAHONEY, LTD
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Dates
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Enumeration Date | 10/30/2013
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Last Update Date | 10/30/2013
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Provider Practice Location Address
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Address Line | 5225 OLD ORCHARD RD SUITE 6
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City | SKOKIE
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State | IL
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Zip | 60077-4405
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Country | US
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Telephone | 847-242-8889
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Fax |
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Provider Business Mailing Address
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Address Line | 5225 OLD ORCHARD RD SUITE 6
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City | SKOKIE
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State | IL
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Zip | 60077-4405
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Country | US
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Telephone | 847-242-8889
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MS. MEGAN C. MAHONEY-MUNO
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Credential | LCPC
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Telephone | 847-242-8889
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180.008001
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License Number State | IL
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