Provider Demographics
NPI:1942631445
Name:MCMAHON, SEAN (BCBA)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:MCMAHON
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 REDFIN DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32233-3901
Mailing Address - Country:US
Mailing Address - Phone:904-329-3317
Mailing Address - Fax:904-329-3318
Practice Address - Street 1:8016 ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-8751
Practice Address - Country:US
Practice Address - Phone:904-329-3317
Practice Address - Fax:904-329-3318
Is Sole Proprietor?:No
Enumeration Date:2013-12-09
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-05-2624103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst