Provider Demographics
NPI:1912899923
Name:MAHANY, AMANDA JEAN (LSW)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:JEAN
Last Name:MAHANY
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 E CATHEDRAL RD STE 45
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-2128
Mailing Address - Country:US
Mailing Address - Phone:215-385-5122
Mailing Address - Fax:
Practice Address - Street 1:4931 WISSAHICKON AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-4800
Practice Address - Country:US
Practice Address - Phone:215-385-5122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW142890104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker