Provider Demographics
NPI:1144500182
Name:MCMAHON, CHRISTINE (LCSW; LICSW)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:
Last Name:MCMAHON
Suffix:
Gender:F
Credentials:LCSW; LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7031 MULLEN RD SE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-4580
Mailing Address - Country:US
Mailing Address - Phone:516-312-9939
Mailing Address - Fax:
Practice Address - Street 1:7031 MULLEN RD SE
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-4580
Practice Address - Country:US
Practice Address - Phone:516-312-9939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-22
Last Update Date:2024-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW614103491041C0700X
NY0780081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical