Individual
TIMOTHY MCMAHON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, SAC-IT
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
20042-130
WI
1041C0700X
Clinical Social Worker
Primary
9396-123
WI
Other
Enumeration date
02/01/2023
Last updated
02/01/2023
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