Individual provider Active NPI

Reena Annetta Manka, CACII

  • Addiction (Substance Use Disorder) Counselor
  • Colorado Springs, CO
National Provider Identifier
1689196180
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
ACB.0007577 Issued in CO
Practice address
888 Garden of the Gods
150
Colorado Springs, CO 80907
Phone
(719) 219-0062
NPI assigned
Jul 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X ACB.0007577 CO Primary

Addresses

Primary practice location

888 Garden of the Gods
150
Colorado Springs, CO 80907

Mailing address

888 Garden of the Gods Rd Ste 150
Colorado Springs, CO 80907-9435

Other practice location 1

619 Wilcox St
Castle Rock, CO 80104
Phone (303) 688-8142

Other identifiers 1

IdentifierTypeStateIssuer
ACB.0007577OtherCOCOLORADO DEPARTMENT OF REGULATORY AGENCIES

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

LicenseStateTypeSpecialty
ACB.0007577COMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1500249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1689196180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 GARDEN OF THE GODS RD STE 150",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809079435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 GARDEN OF THE GODS",
            "address_2": "150",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80907",
            "telephone_number": "719-219-0062"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "619 Wilcox St",
            "address_purpose": "LOCATION",
            "city": "Castle Rock",
            "state": "CO",
            "postal_code": "80104",
            "country_code": "US",
            "telephone_number": "303-688-8142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANKA",
        "first_name": "REENA",
        "middle_name": "ANNETTA",
        "name_prefix": "Miss",
        "credential": "CACII",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "ACB.0007577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO DEPARTMENT OF REGULATORY AGENCIES",
            "identifier": "ACB.0007577",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.