Provider Demographics
NPI:1801190483
Name:MAHONEY, SCHALLER MARIE (MSW)
Entity Type:Individual
Prefix:
First Name:SCHALLER
Middle Name:MARIE
Last Name:MAHONEY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 E 15TH ST STE 400A
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-5046
Mailing Address - Country:US
Mailing Address - Phone:405-216-5240
Mailing Address - Fax:405-285-0294
Practice Address - Street 1:501 E 15TH ST STE 400A
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-5046
Practice Address - Country:US
Practice Address - Phone:405-216-5240
Practice Address - Fax:405-285-0294
Is Sole Proprietor?:No
Enumeration Date:2010-12-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program