Individual provider Active NPI

Melyssa Lee Manock, MLADC

  • Addiction (Substance Use Disorder) Counselor
  • Franklin, NH
National Provider Identifier
1174083455
Registry record updated Jan 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1206 Issued in NH
Practice address
67 Industrial Park Dr
Franklin, NH 03235-2507
Phone
(603) 671-7045
Fax
(603) 556-8456
NPI assigned
Mar 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Addiction (Substance Use Disorder) Counselor 101YA0400X 1206 NH Primary

Addresses

Primary practice location

67 Industrial Park Dr
Franklin, NH 03235-2507

Mailing address

67 Industrial Park Dr
Franklin, NH 03235-2507
Phone (603) 671-7045

Other identifiers 1

IdentifierTypeStateIssuer
1598302523MedicaidNH

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

LicenseStateTypeSpecialty
1206NHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Melyssa Manock, MSW, Mladc, LLC Addiction (Substance Use Disorder) CurrentSince Nov 1, 2020 Accepting new patients
Manchester Alcoholism Rehabilitation Center Addiction (Substance Use Disorder) Past Accepting new patients

Locations

6 Chenell Dr
Ste 100
Concord, NH 03301
Phone (603) 219-4528

67 Industrial Park Dr
Franklin, NH 03235
Phone (603) 671-7045

Organizations & group practices 2

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": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1174083455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 INDUSTRIAL PARK DR",
            "city": "FRANKLIN",
            "state": "NH",
            "postal_code": "032352507",
            "telephone_number": "603-671-7045",
            "fax_number": "603-556-8546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 INDUSTRIAL PARK DR",
            "city": "FRANKLIN",
            "state": "NH",
            "postal_code": "032352507",
            "telephone_number": "603-671-7045",
            "fax_number": "603-556-8456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANOCK",
        "first_name": "MELYSSA",
        "middle_name": "LEE",
        "credential": "MLADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-22",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NH",
            "license": "1206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598302523",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; 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.