Provider Demographics
NPI:1043232440
Name:MAHONEY, GUY JOSEPH (PHD, LCSW, BCD)
Entity Type:Individual
Prefix:DR
First Name:GUY
Middle Name:JOSEPH
Last Name:MAHONEY
Suffix:
Gender:M
Credentials:PHD, LCSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2908 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-6855
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5113 LEESBURG PIKE
Practice Address - Street 2:SUITE 901
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22041-3257
Practice Address - Country:US
Practice Address - Phone:703-578-8539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX192591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical