| Kathleen Mahoney | |
|
3200 Sunset Ave Ste 202 Ocean NJ 07712-4556 | |
| (732) 962-5440 | |
| Not Available |
| Full Name | Kathleen Mahoney |
|---|---|
| Speciality | Social Worker |
| Location | 3200 Sunset Ave Ste 202, Ocean, New Jersey |
| Authorized Official Name and Position | Kathleen Marsh (OWNER) |
| Authorized Official Contact | 7329625440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kathleen Mahoney 81 Pemberton Ave Oceanport NJ 07757-1134 Ph: (732) 962-5440 | Kathleen Mahoney 3200 Sunset Ave Ste 202 Ocean NJ 07712-4556 Ph: (732) 962-5440 |
| NPI Number | 1891235511 |
|---|---|
| Provider Enumeration Date | 02/28/2017 |
| Last Update Date | 02/19/2021 |
| Certification Date | 02/19/2021 |
| Medicare PECOS PAC ID | 0547537565 |
|---|---|
| Medicare Enrollment ID | O20170523002091 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891235511 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 44SC05601000 (New Jersey) | Primary |
| Provider Name | Kathleen Mahoney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093117970 PECOS PAC ID: 1456628478 Enrollment ID: I20170613000524 |
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