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NPI Code Detail

MEDICARE: MARY JOHANNA MAHONEY

MEDICARE: MARY JOHANNA MAHONEY
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
1101YA0400XAddiction (Substance Use Disorder) CounselorBBH-LAC-LIC-70233MT

General Provider Information

NPI Number : 1275497240
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY JOHANNA MAHONEY
Provider Business Mailing Address
First Line : 630 W MERCURY ST
Second Line :
City : BUTTE
State : MT
Zip : 59701-1510
Country : US
Telephone Number : 406-496-1172
Fax Number : 406-782-6964
Provider Business Practice Location Address
First Line : 630 W MERCURY ST
Second Line :
City : BUTTE
State : MT
Zip : 59701-1510
Country : US
Telephone Number : 406-496-1172
Fax Number : 406-782-6964
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2025
Last Update Date : 12/12/2025

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Directions to “ MARY JOHANNA MAHONEY ” Practice Location

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