Provider Demographics
NPI:1194795278
Name:MAHONY, ROSITA AGUILO (LCSW, BCD)
Entity type:Individual
Prefix:MRS
First Name:ROSITA
Middle Name:AGUILO
Last Name:MAHONY
Suffix:
Gender:F
Credentials:LCSW, BCD
Other - Prefix:MRS
Other - First Name:ROSITA
Other - Middle Name:A
Other - Last Name:MAHONY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW, BCD
Mailing Address - Street 1:PSC 490 BOX 9036
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96538
Mailing Address - Country:US
Mailing Address - Phone:671-344-9401
Mailing Address - Fax:671-344-9522
Practice Address - Street 1:FARENHOLT STREET
Practice Address - Street 2:BUILDING K-1
Practice Address - City:AGANA HEIGHTS
Practice Address - State:GU
Practice Address - Zip Code:96919
Practice Address - Country:US
Practice Address - Phone:671-344-9401
Practice Address - Fax:671-344-9522
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI32211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical