Individual provider Active NPI

Marthanne Olivia Manion, MA LMFT

  • Clinical Psychologist
  • Lexington, KY
National Provider Identifier
1457307290
Registry record updated Jun 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
KY90 Issued in KY
Practice address
637 Sayre Ave
Lexington, KY 40508-2317
Phone
(859) 269-1333
Fax
(859) 259-1301
NPI assigned
May 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X KY90 KY Primary
Marriage & Family Therapist 106H00000X KY0418 KY

Addresses

Primary practice location

637 Sayre Ave
Lexington, KY 40508-2317

Mailing address

637 Sayre Ave
Lexington, KY 40508-2317
Phone (859) 269-1333

Other identifiers 2

IdentifierTypeStateIssuer
7573591OtherAETNA
000000331312OtherKYANTHEM BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20200327003165 KY Order and Referring Only - Clinical Psychologist 1850720772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
KY90KYMDClinical Psychologist
KY0418KYMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Keith Haas, LCSW, PLLC PastSince Jun 6, 2017 Accepting new patients

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308009600000",
    "number": "1457307290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 SAYRE AVE",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405082317",
            "telephone_number": "859-269-1333",
            "fax_number": "859-259-1301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 SAYRE AVE",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405082317",
            "telephone_number": "859-269-1333",
            "fax_number": "859-259-1301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANION",
        "first_name": "MARTHANNE",
        "middle_name": "OLIVIA",
        "name_prefix": "Ms.",
        "credential": "MA LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2011-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "KY90",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KY",
            "license": "KY0418",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7573591",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000331312",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.