Melissa Manganello, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11587-123 Issued in WI

Practice address

N14W23777 Stone Ridge Dr Ste 135
Waukesha, WI 53188-1164

Phone

(414) 446-0751

NPI assigned

Sep 9, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Blooming Pathways Therapy LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brookfield, WI
  • NPI 1831910637
  NPD Authorized official
• Empowerment Within LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waukesha, WI
  • NPI 1477155596
  NPD

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

{
    "created_epoch": "1662681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1124749809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N14W23777 STONE RIDGE DR STE 135",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N14W23777 STONE RIDGE DR STE 135",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881164",
            "telephone_number": "414-446-0751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGANELLO",
        "first_name": "MELISSA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-09",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "132080",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "11587-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rada Malinovic, MD
• Angela R Mallmann, PSY.D.
• Joy S Malloy, LCSW
• Lynn Rose Maloney, RN
• Amanda Maly, RD
• Rebecca Nicole Mangino
• Angela Rahoe Maniaci, APNP, NNP
• Sherri J Mann, MD
• David Frederic Mannelli, PSY.D.
• Yvonne Manning

• Clinical Social Worker in Waukesha, WI
• Providers in Waukesha, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.