Active NPI
Diane K Mahoney, PH.D.
- Psychologist
- Concord TWP, OH
National Provider Identifier
1124296108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 4763
- Practice address
- 6835 Morley Rd
Concord TWP, OH 44077-5907 - Phone
- (440) 350-1932
- Fax
- (440) 357-1558
- NPI assigned
- Feb 13, 2008
- Last updated
- Nov 15, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 4763 | OH | Primary |
Addresses
Primary practice location
6835 Morley Rd
Concord TWP, OH 44077-5907
Mailing address
6835 Morley Rd
Concord TWP, OH 44077-5907
Phone (440) 350-1932
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 620004908 | Other | OH | RAILROAD MEDICARE |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4763 | OH | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Halcyon Psychological Services Inc | Psychologist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321315200000",
"number": "1124296108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6835 MORLEY RD",
"city": "CONCORD TWP",
"state": "OH",
"postal_code": "440775907",
"telephone_number": "440-350-1932",
"fax_number": "440-357-1558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6835 MORLEY RD",
"city": "CONCORD TWP",
"state": "OH",
"postal_code": "440775907",
"telephone_number": "440-350-1932",
"fax_number": "440-357-1558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHONEY",
"first_name": "DIANE",
"middle_name": "K",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-13",
"last_updated": "2011-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OH",
"license": "4763",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "620004908",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Concord TWP, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.