Individual provider Active NPI

John Maxwell Manix, MHCAL

  • Mental Health Counselor
  • Spokane, WA
National Provider Identifier
1407586118
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MC61299212 Issued in WA
Practice address
730 N Hamilton St
Spokane, WA 99202-2045
Phone
(509) 458-7686
Fax
(509) 808-2164
NPI assigned
Jun 15, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MC61299212 WA Primary

Addresses

Primary practice location

730 N Hamilton St
Spokane, WA 99202-2045

Mailing address

730 N Hamilton St
Spokane, WA 99202-2045
Phone (509) 458-7686

Other identifiers 1

IdentifierTypeStateIssuer
MC61299212OtherWAASSOCIATES LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20240122004179 WA Practitioner - Mental Health Counselor 6709238025 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MC61299212WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
U District Physical Therapy and Institute of Sports Performance CurrentSince Jan 9, 2024 Accepting new patients

Locations

730 N Hamilton St
Spokane, WA 99202
Phone (509) 458-7686

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": "1655251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1407586118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 N HAMILTON ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992022045",
            "telephone_number": "509-458-7686",
            "fax_number": "509-808-2164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 N HAMILTON ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992022045",
            "telephone_number": "509-458-7686",
            "fax_number": "509-808-2164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANIX",
        "first_name": "JOHN",
        "middle_name": "MAXWELL",
        "credential": "MHCAL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-15",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC61299212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASSOCIATES LICENSE",
            "identifier": "MC61299212",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.