Doctor Name: | MR. TIMOTHY MCMAHON |
NPI Number: | 1336130228 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | LC7508 |
Business Practice Address: | 32 N High St Bridgton, ME - 040091125 |
Business Phone Number: | 2076475629 |
Business Fax Number: | |
Mailing Address: | 32 North High Street, Po Box 170 BRIDGTON |
State: | ME |
Postal Code: | 04040 |
Phone Number: | 2076475629 |
Fax Number: | |
NPI Enumeration Date: | 10/31/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LC7508 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |