Individual
MRS. DEENA M MCMAHON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1026 PORTLAND AVE, SAINT PAUL, MN 55104-7036
(651) 224-7771
Mailing address
1026 PORTLAND AVE, SAINT PAUL, MN 55104-7036
(651) 224-7771
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
02318
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1032816
BEHAVIORAL HEALTHCARE PRO
MN
01
—
173135
UCARE MN
MN
01
—
223JSMC
BCBS
MN
01
—
6233653
UNITED BEHAVIORAL HEALTH
MN
05
—
705220100
—
MN
01
—
HP37572
HEALTH PARTNERS
—
Enumeration date
09/20/2005
Last updated
10/08/2010
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