Justin Manco, CMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

10190973-6004 Issued in UT

Practice address

415 Medical Dr Ste D101
Bountiful, UT 84010-8905

Phone

(801) 683-1062

NPI assigned

Mar 11, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Neurobehavioral Center for Growth LLC

  • Psychologist
  • Bountiful, UT
  • NPI 1942641931
  NPD

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

{
    "created_epoch": "1583884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1992330732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MEDICAL DR STE D101",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840108905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MEDICAL DR STE D101",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840108905",
            "telephone_number": "801-683-1062"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2653 W 1890 N",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "UT",
            "postal_code": "840158478",
            "country_code": "US",
            "telephone_number": "801-589-9121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANCO",
        "first_name": "JUSTIN",
        "credential": "CMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-11",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "10190973-6004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Hubbard Mackay, D.D.S.
• Elisa Madison
• Cristina Thalia Magallanes
• Cambria Maisey
• Vivica Maldonado, RBT
• Mersade Reanna Manis, RBT
• Elizabeth Manley, PSYD
• Nicholas Mann
• Manning Behavior Services, LLC
• Manning Facial Plastic Surgery

• Mental Health Counselor in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Mental Health Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.