Provider Demographics
NPI:1215748850
Name:JEANNE MAHONEY LLC
Entity type:Organization
Organization Name:JEANNE MAHONEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MAHONEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN, LPC
Authorized Official - Phone:609-617-2765
Mailing Address - Street 1:32 SWEDES BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MANNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08079-4019
Mailing Address - Country:US
Mailing Address - Phone:609-617-2765
Mailing Address - Fax:
Practice Address - Street 1:32 SWEDES BRIDGE RD
Practice Address - Street 2:
Practice Address - City:MANNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08079-4019
Practice Address - Country:US
Practice Address - Phone:609-617-2765
Practice Address - Fax:609-208-6552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)