Organization Active NPI

Manna Behavioral Health, Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1912897646
Registry record updated Jul 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MANNA BEHAVIORAL HEALTH, INC
Practice address
1100 N Fern Creek Ave Ste F
Orlando, FL 32803-2628
Phone
(407) 305-7654
NPI assigned
Jul 4, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2025

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

Authorized official

Name
Ms. Carmen A. Ives, APRN, PMHNP-BCNPI 1104565563
Title
Ceo
Phone
(407) 305-7654

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

1100 N Fern Creek Ave Ste F
Orlando, FL 32803-2628

Mailing address

1100 N Fern Creek Ave Ste F
Orlando, FL 32803-2628
Phone (407) 305-7654

Other names 1

  • Manna Behavioral Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250820005327 FL Part B Supplier - Clinic/Group Practice 8224538632 Receives reassigned benefits from 1 practitioner
Practice locations: Orlando, FL

National Provider Directory

National Provider Directory

Locations

1100 N Fern Creek Ave
Ste F
Orlando, FL 32803
Phone (407) 305-7654

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1751587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751587200000",
    "number": "1912897646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 N FERN CREEK AVE STE F",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328032628",
            "telephone_number": "407-305-7654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N FERN CREEK AVE STE F",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328032628",
            "telephone_number": "407-305-7654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANNA BEHAVIORAL HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-04",
        "last_updated": "2025-07-04",
        "certification_date": "2025-07-04",
        "status": "A",
        "authorized_official_last_name": "IVES",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "407-305-7654",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "APRN, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Manna Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.