Tracey Denise Manigault, MA., CSP

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

4241632 Issued in AZ

Practice address

8900 N Central Ave Ste 108F
Phoenix, AZ 85020-2869

Phone

(928) 206-1766

NPI assigned

May 17, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 8

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1494979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722038400000",
    "number": "1386171650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9224 N 2ND AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850213504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 N CENTRAL AVE STE 108F",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202869",
            "telephone_number": "928-206-1766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANIGAULT",
        "first_name": "TRACEY",
        "middle_name": "DENISE",
        "credential": "MA., CSP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-17",
        "last_updated": "2024-07-27",
        "certification_date": "2024-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "AZ",
            "license": "4241632",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "AZ",
            "license": "4241632",
            "primary": true
        },
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374700000X",
            "taxonomy_group": "",
            "desc": "Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED SCHOOL PSYCHOLOGIST",
            "identifier": "4241632",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alicia Mangram, MD
• Jacqueline S Mangrum, LPN
• Michael Ross Mangum
• Tara Mangum, D.O.
• Erin Maniaci, PT, DPT
• Laura Manigo, PA-C, MMS
• Regina M Manion, REGINA MANION
• Angelina Manjarrez
• Carla Jeanene Manjarrez
• Fatima Yarely Manjarrez

• School Psychologist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• School Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2024; 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.