Provider Demographics
NPI:1619137742
Name:AHERN, MARY ELIZABETH (PMHCNS-BC)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:ELIZABETH
Last Name:AHERN
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Gender:F
Credentials:PMHCNS-BC
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Mailing Address - Street 1:750 WASHINGTON ST
Mailing Address - Street 2:BOX #1007
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-1526
Mailing Address - Country:US
Mailing Address - Phone:617-636-6281
Mailing Address - Fax:617-636-4852
Practice Address - Street 1:750 WASHINGTON ST
Practice Address - Street 2:BOX #1007
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1526
Practice Address - Country:US
Practice Address - Phone:617-636-6281
Practice Address - Fax:617-636-4852
Is Sole Proprietor?:No
Enumeration Date:2008-06-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA129645 RN PC364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health