Provider Demographics
NPI:1295079432
Name:MAHONEY, JAMES ARMSTRONG JR (LCSW)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ARMSTRONG
Last Name:MAHONEY
Suffix:JR
Gender:M
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:PO BOX 206
Mailing Address - Street 2:
Mailing Address - City:WILLIS WHARF
Mailing Address - State:VA
Mailing Address - Zip Code:23486-0206
Mailing Address - Country:US
Mailing Address - Phone:757-442-3973
Mailing Address - Fax:
Practice Address - Street 1:281 INDEPENDENCE BLVD
Practice Address - Street 2:S-326
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-2986
Practice Address - Country:US
Practice Address - Phone:757-490-0377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-10
Last Update Date:2012-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040029731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical