Mahon, Jillian Lisa Marie

Mahon, Jillian Lisa Marie is an individual health care provider with primary practice located at 534 E Main St , Medford OR 97504-7118. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Peer Specialist, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Mahon, Jillian Lisa Marie can be contacted via phone (541) 200-1530.

Contact Information

Primary practice address
534 E Main St Medford OR 97504-7118
Phone: (541) 200-1530
Fax: (541) 772-0284
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Peer Specialist 175T00000X
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1679284582
LBN Legal business name Mahon, Jillian Lisa Marie
Credentials CADC-R, CRM
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 12th, 2022
Last updated Feb 13th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679284582 NPPES
Oregon Other THW000104724 TRADITIONAL HEALTH WORKER, PEER SUPPORT SPECIALIST

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