Individual provider Active NPI

Melissa McManis, LCSW

  • Clinical Social Worker
  • Irvine, CA
National Provider Identifier
1063574895
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
26605 Issued in CA
Practice address
19712 Macarthur Blvd
Irvine, CA 92612-2407
Phone
(562) 656-0788
Fax
(916) 857-9402
NPI assigned
Dec 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 156651 CA
Clinical Social Worker 1041C0700X 26605 CA Primary

Addresses

Primary practice location

19712 Macarthur Blvd
Irvine, CA 92612-2407

Mailing address

26861 Via San Jose
Mission Viejo, CA 92691-1812
Phone (562) 656-0788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
156651CAMDSocial Worker
26605CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Melissa McManis, LCSW, Inc CurrentSince Oct 13, 2024 Accepting new patients

Locations

19712 MacArthur Blvd
Irvine, CA 92612
Phone (562) 656-0788

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1063574895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26861 VIA SAN JOSE",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926911812",
            "telephone_number": "562-656-0788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19712 MACARTHUR BLVD",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926122407",
            "telephone_number": "562-656-0788",
            "fax_number": "916-857-9402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMANIS",
        "first_name": "MELISSA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "156651",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "26605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; 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.