Organization
FULL LIVING WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIKITA EMILY-MARIE MAHON LPC (FOUNDER)
(484) 326-9691
Entity
Organization
Contact information
Practice address
5105 PALMER MILL RD, CLIFTON HEIGHTS, PA 19018-1010
(148) 432-6969
Mailing address
1180 BALTIMORE PIKE # 2, SPRINGFIELD, PA 19064-2850
(484) 326-9691
Taxonomy
Speciality
Code
Description
License number
State
101200000X
Drama Therapist
—
—
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
221700000X
Art Therapist
—
—
Other
Enumeration date
09/15/2023
Last updated
12/08/2023
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