Provider Demographics
NPI:1780108514
Name:MAHONEY, JAYME SROKA (LCMFT)
Entity type:Individual
Prefix:MRS
First Name:JAYME
Middle Name:SROKA
Last Name:MAHONEY
Suffix:
Gender:F
Credentials:LCMFT
Other - Prefix:
Other - First Name:JAYME
Other - Middle Name:LAUREN
Other - Last Name:SROKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:124 N. MAIN ST. STE. C
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:MD
Mailing Address - Zip Code:21811
Mailing Address - Country:US
Mailing Address - Phone:410-641-4598
Mailing Address - Fax:410-641-4696
Practice Address - Street 1:124 N. MAIN ST. STE. C
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:MD
Practice Address - Zip Code:21811
Practice Address - Country:US
Practice Address - Phone:410-641-4598
Practice Address - Fax:410-641-4696
Is Sole Proprietor?:No
Enumeration Date:2017-08-02
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist