Mary Christine Mahana, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2017007055 Issued in MO

Practice address

901 Mo 174
Republic, MO 65738-1822

Phone

(417) 732-1822

NPI assigned

Oct 30, 2014

Last updated

Dec 20, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• TLC Transitions Life Center LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kokomo, IN
  • NPI 1447772769
  Authorized official Same address or phone

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

{
    "created_epoch": "1414627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545264000000",
    "number": "1649675885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4319 S NATIONAL AVE PMB 319",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "65810",
            "telephone_number": "417-838-3490",
            "fax_number": "417-763-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 MO 174",
            "city": "REPUBLIC",
            "state": "MO",
            "postal_code": "657381822",
            "telephone_number": "417-732-1822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHANA",
        "first_name": "MARY",
        "middle_name": "CHRISTINE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-30",
        "last_updated": "2018-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2017007055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lester E. Cox Medical Centers (CoxHealth Republic Clinic)
• Cassady A Lilly, MSW, LCSW
• Beverly Jean Long, CRNA, MS
• Tara Denae Long, CF-SLP
• Dwayne L Mackey
• Marcia L. Preston DDS PC Preston Family Dental
• Sarah Marsh, OTR/L
• Sherryl L Marshall
• Stephen Day Maus, D.D.S.
• Crystal Emily May, LMT

• Clinical Psychologist in Republic, MO
• Providers in Republic, MO by specialty
• Clinical Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.