Provider Demographics
NPI:1689753196
Name:MCMAHON, TERESA M (LMHC, CFRC, EMDR)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:M
Last Name:MCMAHON
Suffix:
Gender:F
Credentials:LMHC, CFRC, EMDR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 RED ROOSTER CIR
Mailing Address - Street 2:
Mailing Address - City:MONCKS CORNER
Mailing Address - State:SC
Mailing Address - Zip Code:29461-9618
Mailing Address - Country:US
Mailing Address - Phone:607-382-2099
Mailing Address - Fax:
Practice Address - Street 1:5207 LAKE RD
Practice Address - Street 2:
Practice Address - City:ALFRED STATION
Practice Address - State:NY
Practice Address - Zip Code:14803-9618
Practice Address - Country:US
Practice Address - Phone:607-382-2099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000992-1101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health