Provider Demographics
NPI:1225707094
Name:SWANZEY-MAHON, GENINE (PSYD)
Entity Type:Individual
Prefix:
First Name:GENINE
Middle Name:
Last Name:SWANZEY-MAHON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60752
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20859-0752
Mailing Address - Country:US
Mailing Address - Phone:301-244-9685
Mailing Address - Fax:
Practice Address - Street 1:20 COURTHOUSE SQ STE 216
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-0399
Practice Address - Country:US
Practice Address - Phone:301-244-9685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-07
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06471103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical