Full Living Wellness

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

FULL LIVING WELLNESS

Practice address

5105 Palmer Mill Rd
Clifton Heights, PA 19018-1010

Phone

(148) 432-6969

NPI assigned

Sep 15, 2023

Last updated

Dec 8, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nikita Emily-Marie Mahon, LPCNPI 1265944771

Title

Founder

Phone

(484) 326-9691

Specialties & licenses 6

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nikita Emily-Marie Mahon, MS, NCC, CPRP, LPC

  • Professional Counselor
  • Philadelphia, PA
  • NPI 1265944771

  Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1694736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701993600000",
    "number": "1821876426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 BALTIMORE PIKE # 2",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190642850",
            "telephone_number": "484-326-9691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5105 PALMER MILL RD",
            "city": "CLIFTON HEIGHTS",
            "state": "PA",
            "postal_code": "190181010",
            "telephone_number": "148-432-6969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL LIVING WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-15",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A",
        "authorized_official_last_name": "MAHON",
        "authorized_official_first_name": "NIKITA",
        "authorized_official_middle_name": "EMILY-MARIE",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "484-326-9691",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101200000X",
            "taxonomy_group": "",
            "desc": "Drama Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Clifton Heights, PA
• Providers in Clifton Heights, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; 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.