Provider Demographics
NPI:1740172816
Name:MEREDITH MAHONEY, PSYD PLLC
Entity type:Organization
Organization Name:MEREDITH MAHONEY, PSYD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MEREDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHONEY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:646-580-0313
Mailing Address - Street 1:115 E OGDEN AVE STE 105-249
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-3103
Mailing Address - Country:US
Mailing Address - Phone:646-580-0313
Mailing Address - Fax:
Practice Address - Street 1:116 N WEST ST
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-4347
Practice Address - Country:US
Practice Address - Phone:917-328-9070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)