Madeline Mantilla, M.S.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

003667 Issued in CT

Practice address

401 Shippan Ave
Stamford, CT 06902-6075

Phone

(203) 517-3375

Fax

(203) 353-1524

NPI assigned

Jun 3, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Interoperability endpoints

• Direct secure messaging: madeline.mantilla@chcict.eclinicaldirectplus.com

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

{
    "created_epoch": "1433289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1184004335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 FAIRFIELD AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066044252",
            "telephone_number": "203-394-6529",
            "fax_number": "203-384-8835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 SHIPPAN AVE",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069026075",
            "telephone_number": "203-517-3375",
            "fax_number": "203-353-1524"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "180 Fairfield Ave",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "CT",
            "postal_code": "066044252",
            "country_code": "US",
            "telephone_number": "203-394-6529 x3022",
            "fax_number": "203-384-8835",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANTILLA",
        "first_name": "MADELINE",
        "name_prefix": "Mrs.",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-03",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "003667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanie Mangal
• Schuyler Manhattan
• Sergio G. Manimbo, M.D.
• Nina A Manipon, N.D.
• Madilyn Sarah Mann
• Amira Mantoura, DPM
• Jessica Marcus
• Luba Margai
• Bonnie Margolis, RN
• Mariana Negrila DNP PC

• Professional Counselor in Stamford, CT
• Providers in Stamford, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; 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.