Provider Demographics
NPI:1922827823
Name:MCMAHON, CAROLINE (LPCC)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:MCMAHON
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 N FORK AVE
Mailing Address - Street 2:
Mailing Address - City:PAONIA
Mailing Address - State:CO
Mailing Address - Zip Code:81428-8516
Mailing Address - Country:US
Mailing Address - Phone:910-364-5297
Mailing Address - Fax:
Practice Address - Street 1:225 MINNESOTA AVE
Practice Address - Street 2:
Practice Address - City:PAONIA
Practice Address - State:CO
Practice Address - Zip Code:81428-8503
Practice Address - Country:US
Practice Address - Phone:910-364-5297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0022197101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health