Provider Demographics
NPI:1275797508
Name:BLUE-MCMAHON, CHRISTOPHER ALLEN (CDCA, OCPRS-S, OFRS)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:ALLEN
Last Name:BLUE-MCMAHON
Suffix:
Gender:M
Credentials:CDCA, OCPRS-S, OFRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1351 BELLOWS ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44301-1729
Mailing Address - Country:US
Mailing Address - Phone:330-689-8156
Mailing Address - Fax:
Practice Address - Street 1:1351 BELLOWS ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44301-1729
Practice Address - Country:US
Practice Address - Phone:330-689-8156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-16
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH173323101YA0400X, 101YA0400X
OH0001797175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Yes175T00000XOther Service ProvidersPeer Specialist