Individual provider Active NPI

Mary Colleen Mahoney, LCSW, CADC

  • Mental Health Counselor
  • Chicago, IL
National Provider Identifier
1629706130
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
149.023334 Issued in IL
Practice address
155 N Michigan Ave Ste 380
Chicago, IL 60601-7710
Phone
(773) 340-2616
NPI assigned
Aug 11, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 35837 IL
Mental Health Counselor 101YM0800X 149.023334 IL Primary

Addresses

Primary practice location

155 N Michigan Ave Ste 380
Chicago, IL 60601-7710

Mailing address

870 N State St Apt 2N
Chicago, IL 60610-3333
Phone (224) 406-4641

Other practice location 1

870 N State St Apt 2N
Chicago, IL 60610-3333
Phone (708) 252-3706

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 24, 2026 through Apr 24, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
35837ILMDAddiction (Substance Use Disorder) Counselor
149.023334ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mighty Minds Therapy Center, PLLC CurrentSince Feb 23, 2025 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1660176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1629706130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 N STATE ST APT 2N",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606103333",
            "telephone_number": "224-406-4641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 N MICHIGAN AVE STE 380",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017710",
            "telephone_number": "773-340-2616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "870 N State St Apt 2N",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606103333",
            "country_code": "US",
            "telephone_number": "708-252-3706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "MARY",
        "middle_name": "COLLEEN",
        "credential": "LCSW, CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-11",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "35837",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "149.023334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.