Active NPI
Nicole Mannia, LMHC
- Mental Health Counselor
- Bloomington, IN
National Provider Identifier
1124528310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 39003321A
- Practice address
- 3100 E John Hinkle PL Ste 104
Bloomington, IN 47408 - Phone
- (812) 727-4916
- NPI assigned
- Feb 14, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 39003321A | IN | Primary |
| Mental Health Counselor | 101YM0800X | 88000259A | IN |
Addresses
Primary practice location
3100 E John Hinkle PL Ste 104
Bloomington, IN 47408
Mailing address
3100 John Hinkle PL Suite 104
Bloomington, IN 47408
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39003321A | IN | MD | Mental Health Counselor |
| 88000259A | IN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535760000000",
"number": "1124528310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 JOHN HINKLE PL SUITE 104",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "47408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 E JOHN HINKLE PL STE 104",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "47408",
"telephone_number": "812-727-4916"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANNIA",
"first_name": "NICOLE",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-14",
"last_updated": "2018-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "39003321A",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "88000259A",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.