Provider Demographics
NPI:1326319112
Name:MAHON, MEGAN M (PHD, PCC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:M
Last Name:MAHON
Suffix:
Gender:F
Credentials:PHD, PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1833 S HOLLAND SYLVANIA RD
Mailing Address - Street 2:APT C
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1380
Mailing Address - Country:US
Mailing Address - Phone:419-283-6144
Mailing Address - Fax:
Practice Address - Street 1:5965 RENAISSANCE PL
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4728
Practice Address - Country:US
Practice Address - Phone:419-882-7446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE. 0500624101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional