Edda McManus LCSW LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

007169 Issued in CT

Legal business name

EDDA MCMANUS LCSW LLC

Practice address

567 Vauxhall Street Ext
Suite 314
Waterford, CT 06385-4330

Phone

(860) 440-3838

Fax

(860) 381-5099

NPI assigned

Sep 17, 2013

Last updated

Sep 17, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Edda McManus, LCSWNPI 1871829804

Title

Owner

Phone

(860) 440-3838

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Edda H McManus, LCSW

  • Clinical Social Worker
  • Waterford, CT
  • NPI 1871829804
  Medicare reassignment NPD Authorized official
• Dennis Aurel Goguen, MSW, LCSW

  • Clinical Social Worker
  • Groton, CT
  • NPI 1851339782
  NPD (past)

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379376000000",
    "number": "1619303047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "567 VAUXHALL STREET EXT",
            "address_2": "SUITE 314",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063854330",
            "telephone_number": "860-440-3838",
            "fax_number": "860-381-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "567 VAUXHALL STREET EXT",
            "address_2": "SUITE 314",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063854330",
            "telephone_number": "860-440-3838",
            "fax_number": "860-381-5099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDDA MCMANUS LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-17",
        "last_updated": "2013-09-17",
        "status": "A",
        "authorized_official_last_name": "MCMANUS",
        "authorized_official_first_name": "EDDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-440-3838",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "007169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CBHP004254",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eastern CT Cardiology Diagnostics, LLC
• Eastern CT Health Systems Inc (Fountainview Care Center)
• Eastern Shore Chiropractic Center, L.L.C.
• Erica Ecker, BCBA; LBA-CT
• Marcee Gail Eckert, LO
• Brian S Ehrlich, M.D.
• Christine Elci, PT
• Joyce Morgan Elias, LPC
• Tyler Ellison, L.A.C
• Amr Ahmed Elmeki, M.D.

• Clinical Social Worker in Waterford, CT
• Providers in Waterford, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.