Michael Mancilla Licsw

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MICHAEL MANCILLA LICSW

Practice address

1629 K St NW Ste 300
Washington, DC 20006-1631

Phone

(202) 234-2299

NPI assigned

Jan 5, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Michael A Mancilla, LICSWNPI 1164894929

Title

Therapist/Owner

Phone

(202) 234-2299

Specialties & licenses 1

Addresses

Other names 2

• Michael Mancilla LICSW Other name
• Pride Therapy DC Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Mancilla, LICSW

  • Clinical Social Worker
  • Washington, DC
  • NPI 1164894929
  NPD Authorized official

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

{
    "created_epoch": "1578182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578182400000",
    "number": "1295374478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 NEW YORK AVE NW APT 211",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200014746",
            "telephone_number": "202-234-2299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1629 K ST NW STE 300",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200061631",
            "telephone_number": "202-234-2299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL MANCILLA LICSW",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-05",
        "last_updated": "2020-01-05",
        "certification_date": "2020-01-05",
        "status": "A",
        "authorized_official_last_name": "MANCILLA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "THERAPIST/OWNER",
        "authorized_official_telephone_number": "202-234-2299",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michael Mancilla LICSW",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pride Therapy DC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Michael Mancilla LICSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Michael H Theodoulou
• Michael J. Grady M.D., P.C.
• Michael J. Petite MD PC
• Michael Lu
• Michael M Phillips M.D., P.C.
• Michael Pierre Henson, LLC
• Aleeza Michael-Tabrizi
• Dariola Michael
• Drew Groves Michael, PHD
• Genet Michael, HHA

• Clinical Social Worker in Washington, DC
• Providers in Washington, DC by specialty
• Clinical Social Worker in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2020; 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.