Individual provider Active NPI

Kathleen Mahoney

  • Counselor
  • Beachwood, OH
National Provider Identifier
1609192517
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
E0701191SUPV Issued in OH
Practice address
23412 Commerce Park
Beachwood, OH 44122-5813
Phone
(216) 400-6640
NPI assigned
Apr 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X E0701191SUPV OH Primary
Mental Health Counselor 101YM0800X E0701191SUPV OH
Addiction (Substance Use Disorder) Counselor 101YA0400X E0701191SUPV OH

Addresses

Primary practice location

23412 Commerce Park
Beachwood, OH 44122-5813

Mailing address

23412 Commerce Park
Beachwood, OH 44122-5813
Phone (216) 400-6640

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
E0701191SUPVOHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Miklat Recovery CurrentSince Mar 24, 2025 Accepting new patients

Locations

23412 Commerce Park
Beachwood, OH 44122
Phone (216) 400-6640

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1271376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1609192517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23412 COMMERCE PARK",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225813",
            "telephone_number": "216-400-6640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23412 COMMERCE PARK",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225813",
            "telephone_number": "216-400-6640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-16",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "E0701191SUPV",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E0701191SUPV",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "E0701191SUPV",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; 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.