Individual provider Active NPI

Mary Mahoney, LMSW

  • Counselor
  • Jefferson, GA
National Provider Identifier
1770827446
Registry record updated Nov 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
MSW005777 Issued in GA
Practice address
383 General Jackson Dr
Jefferson, GA 30549-2909
Phone
(706) 389-6789
NPI assigned
Nov 20, 2012
Last updated
Nov 20, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X MSW005777 GA Primary

Addresses

Primary practice location

383 General Jackson Dr
Jefferson, GA 30549-2909

Mailing address

250 North Ave
Athens, GA 30601-2244
Phone (706) 389-6789

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20160719002919 GA Practitioner - Clinical Social Worker 8820381437 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advantage Behavioral Health SystemsGroup PAC ID 1052200599, 33 clinicians

Practice addresses (Care Compare)

240 Mitchell Bridge Rd
Athens, GA 30606-2043
Phone (855) 333-9544

250 Bray St
Athens, GA 30601-2203
Phone 70638967891108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MSW005777GAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Behavioral Health Systems CurrentSince May 23, 2016 Accepting new patients

Locations

240 Mitchell Bridge Rd
Athens, GA 30606
Phone (706) 389-6767

250 Bray St
Athens, GA 30601
Phone (706) 542-9746

250 North Ave
Athens, GA 30601
Phone (706) 542-8656

250 North Ave
Ofc
Athens, GA 30601
Phone (706) 227-7249

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": "1353369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353369600000",
    "number": "1770827446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 NORTH AVE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306012244",
            "telephone_number": "706-389-6789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "383 GENERAL JACKSON DR",
            "city": "JEFFERSON",
            "state": "GA",
            "postal_code": "305492909",
            "telephone_number": "706-389-6789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "MARY",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-20",
        "last_updated": "2012-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "MSW005777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson, GA

Sources for this page

Verify at the official NPI Registry.