Individual
MICHAEL MAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, LCDC
Contact information
Practice address
6633 E HIGHWAY 290, SUITE 212, AUSTIN, TX 78723-1172
(512) 342-1718
Mailing address
6633 E HIGHWAY 290, SUITE 212, AUSTIN, TX 78723-1172
(512) 342-1718
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11603
TX
1041C0700X
Clinical Social Worker
55657
TX
Other
Enumeration date
08/16/2016
Last updated
08/16/2016
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