Active NPI
Pamela Manke, LPC, BCBA, LBA
- Behavior Analyst
- New Britain, CT
National Provider Identifier
1699148122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-17-28659
- Practice address
- 125 Whiting St
New Britain, CT 06051-3184 - Phone
- (860) 415-3776
- NPI assigned
- Nov 5, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2844 | CT | |
| Behavior Analyst | 103K00000X | 1-17-28659 | CT | Primary |
Addresses
Primary practice location
125 Whiting St
New Britain, CT 06051-3184
Mailing address
125 Whiting St
New Britain, CT 06051-3184
Phone (860) 415-3776
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 |
|---|---|---|---|
| 2844 | CT | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1446681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649376000000",
"number": "1699148122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 WHITING ST",
"city": "NEW BRITAIN",
"state": "CT",
"postal_code": "060513184",
"telephone_number": "860-415-3776"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 WHITING ST",
"city": "NEW BRITAIN",
"state": "CT",
"postal_code": "060513184",
"telephone_number": "860-415-3776"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANKE",
"first_name": "PAMELA",
"credential": "LPC, BCBA, LBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-05",
"last_updated": "2022-04-08",
"certification_date": "2022-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CT",
"license": "2844",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CT",
"license": "1-17-28659",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Britain, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.