Individual provider Active NPI

Lucy A Manis, LCPC

  • Counselor
  • Rock Island, IL
National Provider Identifier
1902928484
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
2701 17TH St
Rock Island, IL 61201-5351
Phone
(309) 779-2031
Fax
(309) 779-2055
NPI assigned
Apr 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X IL Primary

Addresses

Primary practice location

2701 17TH St
Rock Island, IL 61201-5351

Mailing address

2701 17TH St
Rock Island, IL 61201-5351
Phone (309) 779-2031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180004895ILMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Robert Young Center for Community Mental Health CurrentSince Jan 1, 2024 Accepting new patients
The Robert Young Center for Community Mental Health CurrentSince Jan 1, 2024 Accepting new patients
The Robert Young Center for Community Mental Health CurrentSince Jan 1, 2024 Accepting new patients
The Robert Young Center for Community Mental Health Current Accepting new patients
The Robert Young Center for Community Mental Health Current Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 1120
Bettendorf, IA 52722
Phone (563) 742-5750

4622 Progress Dr
Ste A
Davenport, IA 52807
Phone (563) 742-5800

1616 Cedar St
Muscatine, IA 52761
Phone (309) 779-3000

2701 17th St
Rock Island, IL 61201
Phone (309) 779-3200

2560 24th St
Ste 101
Rock Island, IL 61201
Phone (309) 779-3970

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902928484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 17TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015351",
            "telephone_number": "309-779-2031",
            "fax_number": "309-779-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 17TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015351",
            "telephone_number": "309-779-2031",
            "fax_number": "309-779-2055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANIS",
        "first_name": "LUCY",
        "middle_name": "A",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Island, IL

Sources for this page

Verify at the official NPI Registry.