Stasia Golembiewska Manak, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW20220 Issued in FL

Practice address

412 S Palmetto Ave
Daytona Beach, FL 32114-4922

Phone

(407) 494-3530

NPI assigned

Aug 1, 2022

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL, DC, TX3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, DC, TX

  Medicare reassignment NPD
• Chrysalis Center, LLC

  • Community/Behavioral Health Agency
  • Fort Lauderdale, FL
  • NPI 1700961646
  NPD (past)

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

{
    "created_epoch": "1659312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1700513702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 S PALMETTO AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321144922",
            "telephone_number": "386-256-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 S PALMETTO AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321144922",
            "telephone_number": "407-494-3530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANAK",
        "first_name": "STASIA",
        "middle_name": "GOLEMBIEWSKA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-01",
        "last_updated": "2022-08-01",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW20220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@chrysalishealth.com",
            "affiliation": "N",
            "address_1": "412 S Palmetto Ave",
            "city": "Daytona Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "321144922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David A Mallory, DC
• Katina Mallory
• Shannon Maloney
• Logan Malter
• Julia Malysh
• Rebecca Hema Mangali, PA-C
• Patrick Terry Mangonon, MD
• Courtney Mangum, MD
• Marissa N Mangum, APRN
• Meredith A. Manley Beck, CRNA

• Clinical Social Worker in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.