Provider Demographics
NPI:1285109793
Name:CHRISTINE MAHONEY COUNSELING FOR BALANCED LIVING
Entity type:Organization
Organization Name:CHRISTINE MAHONEY COUNSELING FOR BALANCED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHONEY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, ACS
Authorized Official - Phone:908-358-6176
Mailing Address - Street 1:131 S EUCLID AVE # 4
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-2129
Mailing Address - Country:US
Mailing Address - Phone:908-358-6176
Mailing Address - Fax:
Practice Address - Street 1:131 S EUCLID AVE # 4
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-2129
Practice Address - Country:US
Practice Address - Phone:908-358-6176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-11
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty