Justice L Manchester, LLMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6851115954 Issued in MI

Practice address

805 W Maumee St
Adrian, MI 49221-1901

Phone

(517) 266-8880

Fax

(517) 266-8881

NPI assigned

Jan 24, 2023

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Parkside Family Counseling, LLC

  • Counselor
  • Adrian, MI
  • NPI 1710164652
  NPD (past)

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

{
    "created_epoch": "1674518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1710693791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 W MAUMEE ST",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211901",
            "telephone_number": "517-266-8880",
            "fax_number": "517-266-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 W MAUMEE ST",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211901",
            "telephone_number": "517-266-8880",
            "fax_number": "517-266-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCHESTER",
        "first_name": "JUSTICE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-24",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851115954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN",
            "identifier": "6851115954",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maya Renee Taylor Mackey
• Rebecca Janess Maddox, DC
• Magnum Health and Rehab of Adrian LLC
• Main St Urgent Care Clinic and Walk in Clinic PC
• Daniel Malcolm
• Lora Jeanette Manders, MA, LLPC, CAADC, PAC
• Gloria Danyale Manica
• Nicole Juliana Elizabeth Mannion, LMT
• Amy Marie Mansfield, BS
• Salah Eldein Mansour, PA-C

• Clinical Social Worker in Adrian, MI
• Providers in Adrian, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; 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.