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General NPI Number Information
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NPI Number | 1952425449
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Entity Type | Individual
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Provider Name | MARY ELIZABETH MAHONEY LCPC
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Gender | Female
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 110 MAIN ST
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City | SACO
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State | ME
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Zip | 04072-3509
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Country | US
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Telephone | 800-434-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 45 SUMMER ST UNIT 3
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City | KENNEBUNK
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State | ME
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Zip | 04043-6636
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CC3106
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License Number State | ME
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