Active NPI
Michael J. Manza, LCSW
- Mental Health Counselor
- Beacon, NY
National Provider Identifier
1023103066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- R057841-1
- Practice address
- 223 Main St
Beacon, NY 12508-2770 - Phone
- (845) 838-4900
- Fax
- (845) 838-4915
- NPI assigned
- Oct 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | R057841-1 | NY | Primary |
Addresses
Primary practice location
223 Main St
Beacon, NY 12508-2770
Mailing address
230 North Rd
Poughkeepsie, NY 12601-1328
Phone (845) 838-4900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070327000528 | NY | Practitioner - Clinical Social Worker | 6103920467 | Practice locations: Cornwall, NY; Croton on Hudson, NY; Poughkeepsie, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
8 Sherwood LN
West Simsbury, CT 06092-2633
9 Windsor Lane
Cornwall, NY 12518-1040
Phone (845) 594-7506
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R057841-1 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023103066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "230 NORTH RD",
"city": "POUGHKEEPSIE",
"state": "NY",
"postal_code": "126011328",
"telephone_number": "845-838-4900",
"fax_number": "845-838-4915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "223 MAIN ST",
"city": "BEACON",
"state": "NY",
"postal_code": "125082770",
"telephone_number": "845-838-4900",
"fax_number": "845-838-4915"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANZA",
"first_name": "MICHAEL",
"middle_name": "J.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "R057841-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beacon, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.