Provider Demographics
NPI:1649026865
Name:OMAHONEY, SUSAN BRIDGET
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:BRIDGET
Last Name:OMAHONEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 QUAIL RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-6144
Mailing Address - Country:US
Mailing Address - Phone:630-580-8080
Mailing Address - Fax:
Practice Address - Street 1:305 QUAIL RIDGE DR
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-6144
Practice Address - Country:US
Practice Address - Phone:630-580-8080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-29
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0213091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical