Provider Demographics
NPI:1912330481
Name:MAHON, BRIDGET E (LMHC)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:E
Last Name:MAHON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:594 GRAND CONCOURSE
Mailing Address - Street 2:SUITE #2
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-5211
Mailing Address - Country:US
Mailing Address - Phone:718-404-9281
Mailing Address - Fax:
Practice Address - Street 1:594 GRAND CONCOURSE
Practice Address - Street 2:SUITE #2
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5211
Practice Address - Country:US
Practice Address - Phone:718-404-9281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-19
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006962-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health