Active NPI
Mykal Manswell
- Professional Counselor
- Peoria, AZ
National Provider Identifier
1649931015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 23889
- Practice address
- 9401 W Thunderbird Rd Ste 188
Peoria, AZ 85381-4210 - Phone
- (623) 263-3972
- NPI assigned
- Jan 6, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 23889 | AZ | Primary |
Addresses
Primary practice location
9401 W Thunderbird Rd Ste 188
Peoria, AZ 85381-4210
Mailing address
PO Box 748465
Atlanta, GA 30374-8465
Phone (855) 284-7483
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 |
|---|---|---|---|
| 23889 | AZ | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thriveworks Clinical - North Carolina PC | Single Specialty | Current | Accepting new patients |
Locations
8406 Six Forks Rd
Ste 104
Raleigh, NC 27615
Phone (855) 675-4144
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.
-
- Mental Health Counselor
- Raleigh, NC
- NPI 1003303082
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776643200000",
"number": "1649931015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 748465",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303748465",
"telephone_number": "855-284-7483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9401 W THUNDERBIRD RD STE 188",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853814210",
"telephone_number": "623-263-3972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANSWELL",
"first_name": "MYKAL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-01-06",
"last_updated": "2026-04-20",
"certification_date": "2026-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "23889",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.