Active NPI
George James Manko, LICSW
- Clinical Social Worker
- Warwick, RI
National Provider Identifier
1801917158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- ISW00631
- Practice address
- 615 Jefferson Blvd
Suite 208B
Warwick, RI 02886-1357 - Phone
- (401) 737-6436
- Fax
- (401) 732-1228
- NPI assigned
- Apr 3, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ISW00631 | RI | Primary |
Addresses
Primary practice location
615 Jefferson Blvd
Suite 208B
Warwick, RI 02886-1357
Mailing address
615 Jefferson Blvd
Suite 208B
Warwick, RI 02886-1357
Phone (401) 737-6436
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 406570 | Other | RI | BLUE CHIP |
| 30185-5 | Other | RI | BLUE CROSS & BLUE SHIELD |
| 1021900 | Other | RI | BEACON HEALTH STRATEGIES |
| 6200364 | Other | RI | UNITED BEHAVIORAL HEALTH |
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Providence Center | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Providence, RI
- NPI 1134977598
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801917158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 JEFFERSON BLVD",
"address_2": "SUITE 208B",
"city": "WARWICK",
"state": "RI",
"postal_code": "028861357",
"telephone_number": "401-737-6436",
"fax_number": "401-732-1228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 JEFFERSON BLVD",
"address_2": "SUITE 208B",
"city": "WARWICK",
"state": "RI",
"postal_code": "028861357",
"telephone_number": "401-737-6436",
"fax_number": "401-732-1228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANKO",
"first_name": "GEORGE",
"middle_name": "JAMES",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "RI",
"license": "ISW00631",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHIP",
"identifier": "406570",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS & BLUE SHIELD",
"identifier": "30185-5",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEACON HEALTH STRATEGIES",
"identifier": "1021900",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED BEHAVIORAL HEALTH",
"identifier": "6200364",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Warwick, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.