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NPI Code Detail

MEDICARE: NIKITA EMILY-MARIE MAHON MS, NCC, CPRP, LPC

MEDICARE: NIKITA EMILY-MARIE MAHON MS, NCC, CPRP, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2101YP2500XProfessional CounselorPC013002PA

General Provider Information

NPI Number : 1265944771
Entity Type Code : Individual
Provider Name (Legal Business Name) : NIKITA EMILY-MARIE MAHON MS, NCC, CPRP, LPC
Provider Business Mailing Address
First Line : 1180 BALTIMORE PIKE # 2
Second Line :
City : SPRINGFIELD
State : PA
Zip : 19064-2850
Country : US
Telephone Number : 484-326-9691
Fax Number :
Provider Business Practice Location Address
First Line : 2566 FRANKFORD AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19125-1743
Country : US
Telephone Number : 215-397-2943
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2017
Last Update Date : 09/20/2023

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