Stephanie Gill-Manville, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

001752 Issued in CT

Practice address

21 Montauk Avene
New London, CT 06320-6397

Phone

(860) 271-4700

Fax

(860) 271-4797

NPI assigned

Oct 10, 2008

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Mental Health Counselor

Education

Other, 2006

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Connecticut Behavioral Health Assoc PCGroup PAC ID 4385532373, 38 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stephanie.gill-manville.1@32885.direct.athenahealth.com
• FHIR API: https://api.qualifacts.org/api/fhir/soundcommunityservices/r4/

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.

• Connecticut Behavioral Health Assoc, P.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New London, CT
  • NPI 1629158126

  Professional

  Medicare reassignment Care Compare group NPD
• Journey to You, LLC

  • Professional Counselor
  • Jewett City, CT
  • NPI 1215634662
  Medicare reassignment NPD Authorized official
• Sound Community Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New London, CT
  • NPI 1396700886
  NPD (past)

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

{
    "created_epoch": "1223596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1376795112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 390",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063200390",
            "telephone_number": "860-271-4700",
            "fax_number": "860-271-4797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 MONTAUK AVENE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063206397",
            "telephone_number": "860-271-4700",
            "fax_number": "860-271-4797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL-MANVILLE",
        "first_name": "STEPHANIE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-10",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "001752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004253027",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Genoa Healthcare LLC
• Mylene Geronimo, APRN
• Samantha Joan Giangrande, PSYD
• Meghan Marie Gibson, PA
• Kelly Giffault, PA
• John T Gilleese III, LADC
• Lisa M Gilmore, RN, MSN, MBA, CDE
• Ellen Gingerella, PA-C
• Robert Ginther, PA
• Bernard A. Giserman, M.D.

• Professional Counselor in New London, CT
• Providers in New London, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.