Robert Grenfell Mankoff, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

1963 Issued in NC

Practice address

4000 Blue Ridge Rd
Suite 200
Raleigh, NC 27612-4650

Phone

(919) 782-4981

Fax

(919) 782-2474

NPI assigned

Feb 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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.

• Freshwinds, Inc

  • Clinical Social Worker
  • Raleigh, NC
  • NPI 1861534794

  Clinical Child & Adolescent

  NPD (past)
• Youth Development Corporation of America

  • Community/Behavioral Health Agency
  • Raleigh, NC
  • NPI 1952518110
  NPD (past)

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104951136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4029 BALSAM DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276123605",
            "telephone_number": "919-781-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 BLUE RIDGE RD",
            "address_2": "SUITE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276124650",
            "telephone_number": "919-782-4981",
            "fax_number": "919-782-2474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANKOFF",
        "first_name": "ROBERT",
        "middle_name": "GRENFELL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NC",
            "license": "1963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000666",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eva M Manitius, M.D.
• Vaishali Sukhani Mankad, MD
• Kassidy Lorraine Manke, MS, RDN, LDN
• Emma Gray Mankin, LCSWA
• Keith P Mankin, MD
• Alison R Mann, LCSW
• Brian Mann, MA, LPC
• Celeta Marie Mann
• Courtney H Mann, MD
• James Tift Mann III, M.D.

• Clinical Child & Adolescent Psychologist in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinical Child & Adolescent Psychologist in North Carolina

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.