Individual
KELLY M MAHONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP- BC
Contact information
Practice address
33 TOWER ST, SOMERVILLE, MA 02143-1426
(617) 591-4500
Mailing address
2808 HUGUENOT TRL, POWHATAN, VA 23139-4308
(910) 603-6162
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
0024185585
NC
2084P0800X
Psychiatry Physician
239268
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5010931
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN2357709
MA
Other
Enumeration date
09/05/2018
Last updated
06/24/2025
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