Shane Michael Mahon, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10350 Issued in CT

Practice address

262 State St Ste C
North Haven, CT 06473-2273

Phone

(203) 980-7454

NPI assigned

Sep 20, 2018

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Anchored Soul Counseling, PLLC

  • Clinical Social Worker
  • North Haven, CT
  • NPI 1619515962
  NPD Authorized official

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

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1841774254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 MOHAWK DR",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064732801",
            "telephone_number": "203-980-7454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 STATE ST STE C",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064732273",
            "telephone_number": "203-980-7454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHON",
        "first_name": "SHANE",
        "middle_name": "MICHAEL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-20",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "10350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antonio D.S. Lopez, M.D.
• Roger A Lowlicht
• LP Counseling Services, LLC
• Molly Ludwig, APRN
• Petar Lujic, MD
• Steven Mahoney Jr., LCSW
• Jacqueline Maisonpierre, MS
• Darren Major
• Corey Kyle Malan
• Alex Nikhil Malhotra

• Clinical Social Worker in North Haven, CT
• Providers in North Haven, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2020; 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.