Individual provider Active NPI

Katie Mahon

  • Clinical Social Worker
  • Bangor, ME
National Provider Identifier
1093606733
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
MC26112 Issued in ME
Practice address
268 Stillwater Ave
Bangor, ME 04401-3980
Phone
(207) 973-6100
NPI assigned
Jul 11, 2025
Reactivated
Jul 20, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X MC26112 ME Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X CAC6539 ME

Addresses

Primary practice location

268 Stillwater Ave
Bangor, ME 04401-3980

Mailing address

134 Union St
Brewer, ME 04412-2037
Phone (978) 879-6435

Other practice location 1

700 Mount Hope Ave Ste 480
Bangor, ME 04401-5659
Phone (207) 847-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CAC6539MEMDAddiction (Substance Use Disorder) Counselor
LS21523MEMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1752192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1093606733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 UNION ST",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044122037",
            "telephone_number": "978-879-6435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 STILLWATER AVE",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013980",
            "telephone_number": "207-973-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Mount Hope Ave Ste 480",
            "address_purpose": "LOCATION",
            "city": "Bangor",
            "state": "ME",
            "postal_code": "044015659",
            "country_code": "US",
            "telephone_number": "207-847-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHON",
        "first_name": "KATIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-11",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "deactivation_date": "2026-06-09",
        "reactivation_date": "2026-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "MC26112",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "CAC6539",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.