1689753196 NPI number — MS. TERESA M MCMAHON LMHC, CFRC, EMDR TR

Table of content: DONNA CAROLINA CAMACHO (NPI 1083257661)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689753196 NPI number — MS. TERESA M MCMAHON LMHC, CFRC, EMDR TR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCMAHON
Provider First Name:
TERESA
Provider Middle Name:
M
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LMHC, CFRC, EMDR TR
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689753196
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/13/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
111 RED ROOSTER CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONCKS CORNER
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29461-9618
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
607-382-2099
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
TERESA MCMAHON, LMHC, CFRC, EMDR T
Provider Second Line Business Practice Location Address:
35 LANTERN LANE
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14623
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
607-382-2099
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  000992-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: 000992 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2026 www.npivalidator.com