Kelli Ann Manzano, LCSW-C, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

DP00944880 Issued in WV

Practice address

142 N Queen St
Martinsburg, WV 25401

Phone

(304) 596-0486

Fax

(304) 760-5945

NPI assigned

Dec 28, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Washington County Health Department-Cameo

  • State or Local Public Health Clinic/Center
  • Hagerstown, MD
  • NPI 1396269577
  NPD (past)
• Washington County Health Department-Cameo

  • Addiction (Substance Use Disorder) Counselor
  • Hagerstown, MD
  • NPI 1427456631
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1261958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528848000000",
    "number": "1003146978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 N QUEEN ST",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254013312",
            "telephone_number": "304-596-0486",
            "fax_number": "304-760-5945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 N QUEEN ST",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "25401",
            "telephone_number": "304-596-0486",
            "fax_number": "304-760-5945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 Hospital Way",
            "address_purpose": "LOCATION",
            "city": "Hagerstown",
            "state": "MD",
            "postal_code": "217422741",
            "country_code": "US",
            "telephone_number": "240-313-3321",
            "fax_number": "301-790-1314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANZANO",
        "first_name": "KELLI",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LCSW-C, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-28",
        "last_updated": "2018-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "17093",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "DP00944880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Malloy
• Managed Home Health
• Ian Michael Mangus, COTA/L
• Chris Manley, RD
• Kiran Mann
• Maple & Moon Midwifery
• Haley Marchi
• Nora E Markland, MA
• Peter Markovic, M.D.
• Jennifer Anne Markovits

• Clinical Social Worker in Martinsburg, WV
• Providers in Martinsburg, WV by specialty
• Clinical Social Worker in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.