Samuel Benjamin Manz, LPC

Individual provider Active NPI School Counselor · Paulding, OH

NPI 1972030039 · NPPES record last updated Mar 17, 2018

Key facts

NPI
1972030039
Entity type
Individual (NPI type 1)
Primary specialty
School Counselor 101YS0200X
License
OH1260965 (OH)
Practice address
501 MC Donald Pike
Paulding, OH 45879-9239
Phone
(419) 399-3636
Fax
(419) 399-5915
NPI assigned
May 18, 2017
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1200153OHMDProfessional Counselor
OH1260965OHMDSchool Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1200153 OH
School Counselor 101YS0200X OH1260965 OH Yes

Addresses

Primary practice location

501 MC Donald Pike
Paulding, OH 45879-9239

Mailing address

501 MC Donald Pike
Paulding, OH 45879-9239
Phone (419) 399-3636

Other practice location 1

501 Mc Donald Pike
Paulding, OH 45879-9239

Other providers in Paulding, OH

All providers in Paulding, OH · School Counselor in Ohio

Sources for this page

Verify at the official NPI Registry.