Active NPI
Krista Marie-Merezko Manton, LPC
- Professional Counselor
- Laramie, WY
National Provider Identifier
1881773083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC894
- Practice address
- 1050 N 3Rd St
Suite B-1
Laramie, WY 82072-2544 - Phone
- (307) 742-4769
- Fax
- (307) 742-6702
- NPI assigned
- Nov 6, 2006
- 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 | LPC894 | WY | Primary |
| Counselor | 101Y00000X | LPC #894 | WY |
Addresses
Primary practice location
1050 N 3Rd St
Suite B-1
Laramie, WY 82072-2544
Mailing address
1050 N 3Rd St
Suite B-1
Laramie, WY 82072-2544
Phone (307) 742-4769
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 |
|---|---|---|---|
| LPC #894 | WY | MD | Counselor |
| LPC894 | WY | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alliance for Growth | Professional | 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.
-
- Professional Counselor
- Laramie, WY
- NPI 1760653596
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349827200000",
"number": "1881773083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1050 N 3RD ST",
"address_2": "SUITE B-1",
"city": "LARAMIE",
"state": "WY",
"postal_code": "820722544",
"telephone_number": "307-742-4769",
"fax_number": "307-742-6702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 N 3RD ST",
"address_2": "SUITE B-1",
"city": "LARAMIE",
"state": "WY",
"postal_code": "820722544",
"telephone_number": "307-742-4769",
"fax_number": "307-742-6702"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANTON",
"first_name": "KRISTA",
"middle_name": "MARIE-MEREZKO",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-06",
"last_updated": "2012-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WY",
"license": "LPC894",
"primary": true
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WY",
"license": "LPC #894",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laramie, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.