Manifest Family Services

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

MANIFEST FAMILY SERVICES

Doing business as

Manifest Family Services

Practice address

110 Stockton St Ste M
Statesville, NC 28677-5253

Phone

(980) 446-0004

Fax

(980) 446-0004

NPI assigned

Feb 3, 2021

Organization subpart

No

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

Authorized official

Name

Marguerite Anne Allen, M.DIVNPI 1427031392

Title

Program Director

Phone

(980) 446-0004

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Manifest Family Services Doing business as

Electronic endpoints 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marguerite A Allen, D.MIN, LCMHCS, LCASA

  • Professional Counselor
  • Statesville, NC
  • NPI 1427031392
  NPD Authorized official

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

{
    "created_epoch": "1612310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623974400000",
    "number": "1033700836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1702",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286871702",
            "telephone_number": "980-446-0004",
            "fax_number": "980-446-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 STOCKTON ST STE M",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286775253",
            "telephone_number": "980-446-0004",
            "fax_number": "980-446-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANIFEST FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-03",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARGUERITE",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "980-446-0004",
        "authorized_official_credential": "M.DIV"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6104321",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Healthconnex",
            "affiliation": "N",
            "endpointDescription": "NC State",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "NC State",
            "address_1": "110 Stockton St Ste M",
            "city": "Statesville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "286775253",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "healthconnex",
            "affiliation": "Y",
            "endpointDescription": "state site",
            "affiliationName": "Manifest Family Services",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "110 Stockton St Ste M",
            "city": "Statesville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "286775253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Manifest Family Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Manifest Family Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emmylou Sigmon Madison, LCMHC
• Christionna Lakenda Malachi
• Katharine Schultheis Mallory, FNP
• Mamassist Management, Inc
• Tracy Mangum
• Christina Marie Mann, PHD, CRC, NCC, BCBA
• Joseph Stephen Manser III, M.A.
• Mario Zapata, M.D., P.C.
• Brandon Terrell Marion, MD
• Mark B Williamson, MD PA

• Professional Counselor in Statesville, NC
• Providers in Statesville, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; 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.