Individual provider Active NPI

Derrick C Manora, LPC

  • Professional Counselor
  • Montgomery, AL
National Provider Identifier
1205334356
Registry record updated Jul 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2263 Issued in AL
Practice address
7085 Sydney Curv
Montgomery, AL 36117-3509
Phone
(334) 270-5502
NPI assigned
Jan 23, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2263 AL Primary

Addresses

Primary practice location

7085 Sydney Curv
Montgomery, AL 36117-3509

Mailing address

7012 Caddie CV
Montgomery, AL 36116-6029
Phone (334) 467-4071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240517002322 AL Practitioner - Mental Health Counselor 8729429931 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gardenia Cove Mental Health PCGroup PAC ID 0648534537, 40 clinicians

Practice addresses (Care Compare)

7475 Halcyon Pointe Dr
Montgomery, AL 36117-8053
Phone (334) 954-6010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gardenia Cove Mental Health PC CurrentSince Apr 24, 2024 Accepting new patients

Locations

7475 Halcyon Pointe Dr
Montgomery, AL 36117
Phone (334) 954-6010

Organizations & group practices 1

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": "1516665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1205334356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7012 CADDIE CV",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361166029",
            "telephone_number": "334-467-4071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7085 SYDNEY CURV",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173509",
            "telephone_number": "334-270-5502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANORA",
        "first_name": "DERRICK",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-23",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AL",
            "license": "2263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.