Provider Demographics
NPI:1801542741
Name:MAHANAY, PATRICIA LYNN (PSYCHIATRIC TECH)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LYNN
Last Name:MAHANAY
Suffix:
Gender:
Credentials:PSYCHIATRIC TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 BUSTER CHATHAM RD STE 36
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76705-5473
Mailing Address - Country:US
Mailing Address - Phone:305-250-8370
Mailing Address - Fax:
Practice Address - Street 1:6824 LOGUE LN
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76708-7241
Practice Address - Country:US
Practice Address - Phone:254-327-2001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-01
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT30309167G00000X
CA30309101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health