Michael John Maniscalco, MA, LLPC, CACLL
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Memphis, MI
NPI 1023112166 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1023112166
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 6401009720 (MI)
- Practice address
- 400 Stoddard Rd.
Memphis, MI 48041-1038 - Phone
- (810) 392-2167
- NPI assigned
- Sep 11, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401009720 | MI | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 6401009720 | MI | Yes |
Addresses
Primary practice location
400 Stoddard Rd.
Memphis, MI 48041-1038
Mailing address
112 Pleasant St
Romeo, MI 48065-5141
Phone (810) 392-2167
Other providers in Memphis, MI
- Mary Ann Golish
- Nicola Iosif Jaksa
- Pamela Jones
- Larry Gideon, M D
- Lois Macdonald
- Nancy Carole Mills
- Cindy Lee Nash
- Sacred Heart
- Anna Marie Saghy
- Smidi Drugs Inc
All providers in Memphis, MI · Addiction (Substance Use Disorder) Counselor in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.