Provider Demographics
NPI:1700531597
Name:MAHONE, ANAIS (LCSW)
Entity Type:Individual
Prefix:
First Name:ANAIS
Middle Name:
Last Name:MAHONE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 DAVIDSON RD APT 127
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-8109
Mailing Address - Country:US
Mailing Address - Phone:551-655-4331
Mailing Address - Fax:
Practice Address - Street 1:190 DAVIDSON RD APT 127
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-8109
Practice Address - Country:US
Practice Address - Phone:551-655-4331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-21
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC059418001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical