Active NPI
Emmanuel Christian Manley Sr., LCAS-A
- Addiction (Substance Use Disorder) Counselor
- Concord, NC
National Provider Identifier
1497095673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 4211 Four Winds CT SW
Concord, NC 28027-0413 - Phone
- (803) 371-3172
- NPI assigned
- Feb 25, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | NC | Primary | |
| Mental Health Counselor | 101YM0800X | 1497095673 | NC |
Addresses
Primary practice location
4211 Four Winds CT SW
Concord, NC 28027-0413
Mailing address
4211 Four Winds CT SW
Concord, NC 28027-0413
Phone (803) 371-3172
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101YM0800X | Other | NC | 101YM0800X MENTAL HEALTH |
| 1497095673 | Medicaid | NC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1497095673 | NC | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1361750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377820800000",
"number": "1497095673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4211 FOUR WINDS CT SW",
"city": "CONCORD",
"state": "NC",
"postal_code": "280270413",
"telephone_number": "803-371-3172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4211 FOUR WINDS CT SW",
"city": "CONCORD",
"state": "NC",
"postal_code": "280270413",
"telephone_number": "803-371-3172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANLEY",
"first_name": "EMMANUEL",
"middle_name": "CHRISTIAN",
"name_suffix": "Sr.",
"credential": "LCAS-A",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-02-25",
"last_updated": "2013-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": null,
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "1497095673",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "101YM0800X MENTAL HEALTH",
"identifier": "101YM0800X",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1497095673",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Concord, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.