Provider Demographics
NPI:1457409203
Name:MCMAHON, JAMES EDWARD (LCSW-LMFT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:EDWARD
Last Name:MCMAHON
Suffix:
Gender:M
Credentials:LCSW-LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MINE HILL RD
Mailing Address - Street 2:
Mailing Address - City:CORNWALL
Mailing Address - State:NY
Mailing Address - Zip Code:12518-1806
Mailing Address - Country:US
Mailing Address - Phone:914-805-5546
Mailing Address - Fax:
Practice Address - Street 1:5 MINE HILL ROAD
Practice Address - Street 2:
Practice Address - City:CORNWALL
Practice Address - State:NY
Practice Address - Zip Code:12518-1806
Practice Address - Country:US
Practice Address - Phone:914-805-5546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR035065-11041C0700X
NYR0350651041C0700X
NY000293-1106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
N8R1506181Medicare UPIN