Individual provider Active NPI

Michael John Manor, LPC, LMHC

  • Mental Health Counselor
  • Eau Claire, WI
National Provider Identifier
1376055772
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH00006162 Issued in WA
Practice address
936 Summer St
Eau Claire, WI 54701-4240
Phone
(206) 713-1521
NPI assigned
Oct 25, 2017
Last updated
Jul 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6401013624 MI
Mental Health Counselor 101YM0800X 4520-125 WI
Professional Counselor 101YP2500X MI
Professional Counselor 101YP2500X WI
Mental Health Counselor 101YM0800X LH00006162 WA Primary

Addresses

Primary practice location

936 Summer St
Eau Claire, WI 54701-4240

Mailing address

936 Summer St
Eau Claire, WI 54701-4240
Phone (206) 713-1521

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
6401013624MIMDMental Health Counselor
LH00006162WAMDMental Health Counselor
4520-125WIMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1508889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1376055772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "936 SUMMER ST",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547014240",
            "telephone_number": "206-713-1521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "936 SUMMER ST",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547014240",
            "telephone_number": "206-713-1521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANOR",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "credential": "LPC, LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-25",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401013624",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "4520-125",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00006162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; 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.