Kristina Lynn Manchester, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

107177 Issued in NY

Practice address

650 State St
Watertown, NY 13601-2839

Phone

(315) 755-1251

Fax

(315) 291-6601

NPI assigned

Dec 11, 2019

Last updated

Jun 13, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Citizen Advocates, Inc

  dba North Star Behavioral Health Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Malone, NY
  • NPI 1780619064
  NPD

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

{
    "created_epoch": "1576022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1649818568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 WEST ST",
            "city": "CARTHAGE",
            "state": "NY",
            "postal_code": "136199776",
            "telephone_number": "315-493-1000",
            "fax_number": "315-493-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 STATE ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012839",
            "telephone_number": "315-755-1251",
            "fax_number": "315-291-6601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9508 Artz Road",
            "address_2": "Beaver River School Based Clinic",
            "address_purpose": "LOCATION",
            "city": "Beaver Falls",
            "state": "NY",
            "postal_code": "13305",
            "country_code": "US",
            "telephone_number": "315-346-3306",
            "fax_number": "315-346-6005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANCHESTER",
        "first_name": "KRISTINA",
        "middle_name": "LYNN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-11",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "107177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Libby Anne Malcolm
• Alvin Hugh Andrew Maloney, MD
• Judith Anne Maloney, ANP
• Simi Rachel Mammen, MD
• Sydnie Rae Manarina
• Meghan Manisero, DDS
• Belinda J Mannigan, PT, DPT
• Brittany Bliss Manninen, RPH
• Marisa Ann Marcellus, OTR
• Martina L Marcinko

• Social Worker in Watertown, NY
• Providers in Watertown, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.