Provider Demographics
NPI:1710579420
Name:THOMAS M O'MAHONY, LCSW, LLC
Entity Type:Organization
Organization Name:THOMAS M O'MAHONY, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:O'MAHONY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:724-877-8595
Mailing Address - Street 1:4002 HERMITAGE HILLS BLVD APT 10
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-3423
Mailing Address - Country:US
Mailing Address - Phone:724-877-8595
Mailing Address - Fax:724-297-3131
Practice Address - Street 1:50 SNYDER RD STE 1
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-3432
Practice Address - Country:US
Practice Address - Phone:724-877-8595
Practice Address - Fax:724-297-3131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty