Individual
MOLLY MCMAHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
165 LANCASTER ST, PORTLAND, ME 04101-2406
(207) 874-1030
Mailing address
78 ATLANTIC PL, SOUTH PORTLAND, ME 04106-2316
(207) 842-6540
(207) 842-7773
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC10869
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432623099
—
ME
Enumeration date
04/28/2009
Last updated
05/18/2011
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