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General NPI Number Information
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NPI Number | 1336008192
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Entity Type | Organization
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Legal Business Name | MICHELLE MAHONEY, LCSW LLC
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Dates
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Enumeration Date | 01/19/2026
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Last Update Date | 01/19/2026
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Provider Practice Location Address
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Address Line | 4265 BROOKFIELD CORPORATE DR UNIT D
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City | CHANTILLY
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State | VA
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Zip | 20151-1696
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Country | US
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Telephone | 540-724-6116
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Fax |
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Provider Business Mailing Address
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Address Line | 6038 SMOOTH STONE PL
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City | HAYMARKET
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State | VA
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Zip | 20169-3310
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Country | US
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Telephone | 540-724-6116
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MICHELLE MAHONEY
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Credential | LCSW
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Telephone | 540-724-6116
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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 |
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License Number State |
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