MS. ANNETTE MANCUSO (NPI# 1679694277) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679694277 |
| Entity Type | Individual |
| Full Name | MS. ANNETTE MANCUSO |
| Other Name | MS. ANNETTE MANCUSO |
| Credential | LPC |
| Practice Address |
2401 Mustang Dr Suite 200 Grapevine TX 76051-8640 |
| Practice Telephone | 8174817474 |
| Practice Fax Number | 8174160900 |
| Mailing Telephone | 8174817474 |
| Mailing Fax Number | 8174160900 |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2017-11-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
15838 | TX | Behavioral Health & Social Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP135862 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2401 MUSTANG DR SUITE 200 |
| City | GRAPEVINE |
| State | TX |
| Zip Code | 76051-8640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346316809 | Karen Falterer | Social Worker | 2401 Mustang Dr, Suite# 200, Grapevine, TX 76051-8640 | 2006-11-27 |
| 1154938538 | Shelby Rabjohn | Behavior Technician | 2401 Mustang Dr, Grapevine, TX 76051-8640 | 2020-09-29 |
| 1083229306 | Carrie Henderson | Behavior Technician | 2401 Mustang Dr, Grapevine, TX 76051-8640 | 2020-09-14 |
| 1386255875 | Keyonna Lamb | Behavior Technician | 2401 Mustang Dr, Grapevine, TX 76051-8640 | 2020-08-10 |
| 1689285140 | Kaylan Hardin | Behavior Technician | 2401 Mustang Dr, Grapevine, TX 76051-8640 | 2020-08-10 |
| 1063022283 | Katherine Vara | Behavior Technician | 2401 Mustang Dr, Grapevine, TX 76051-8640 | 2020-08-03 |
| 1487270096 | Brookley Baker | Behavior Technician | 2401 Mustang Dr, Grapevine, TX 76051-8640 | 2020-06-19 |
| 1669098281 | Alexis Mckinney | Behavior Technician | 2401 Mustang Dr, Grapevine, TX 76051-8640 | 2020-06-19 |
| 1841814316 | Savannah Miller | Behavior Technician | 2401 Mustang Dr, Grapevine, TX 76051-8640 | 2020-06-01 |
| 1255954699 | Alexandra Broyles | Behavior Technician | 2401 Mustang Dr, Grapevine, TX 76051-8640 | 2020-05-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881227346 | Jeffrey Joseph Cervenka | Physical Therapist | 2421 Ira E Woods Ave #101, Grapevine, TX 76051 | 2020-02-12 |
| 1871137562 | Karen Lorince | Counselor | 2409 N. Support Road, Grapevine, TX 76051 | 2019-11-05 |
| 1548733785 | Jessica Thorman Johnson | Dietitian, Registered | 1056 Texan Trail (fortis Bmi), Grapevine, TX 76051 | 2019-01-10 |
| 1164928958 | Kristen Diou | Counselor | 913 S Church St Ste 103, Grapevine, TX 76051 | 2018-04-02 |
| 1356860597 | Anissa Singratanakul D.m.d, Pllc | Dentist | 1231 William D Tate Suite 400, Grapevine, TX 76051 | 2017-09-19 |
| 1033637665 | James Abraham Thomas | Pharmacy | 1601 W. State Hwy 114, Grapevine, TX 76051 | 2017-09-04 |
| 1437606563 | D'anna Sims | Counselor | 2451 Stone Myers Parkway, #100, Grapevine, TX 76051 | 2016-09-07 |
| 1477006369 | Melinda Jeanne Mashburn | Nurse Practitioner | 1600 West College St., Suite 60, Grapevine, TX 76051 | 2016-07-27 |
| 1437506623 | Allcare Physicians Group | Registered Nurse | 1111 S Main St Ste 119, Grapevine, TX 76051 | 2016-05-18 |
| 1790141745 | Colwick Counseling | Clinic/Center | 1400 W. Northwest Highway Suite 260, Grapevine, TX 76051 | 2016-01-06 |
| Find all providers in zip 76051 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508496613 | Catherine Elaine Reed | Nurse Practitioner | 922 Surrey Ln, Grapevine, TX 76051-5141 | 2020-01-17 |
| 1649830332 | Zekendra Clovis | Nurse Practitioner | 2300 Timberline Dr Apt 155, Grapevine, TX 76051-4362 | 2019-06-16 |
| 1548734999 | Callie Marie Ramsey | Nurse Practitioner | 1813 Redwood Trl, Grapevine, TX 76051-3057 | 2019-01-18 |
| 1033690839 | Kimberly Loraine Kammerer | Nurse Practitioner | 1601 Lancaster Dr Ste 10b, Grapevine, TX 76051-3500 | 2018-08-28 |
| 1811483407 | Kelli Fletcher | Nurse Practitioner | 1600 W College St Ste 140, Grapevine, TX 76051-3575 | 2018-07-06 |
| 1740604560 | Mariagorety Nwiloh | Nurse Practitioner | 3408 Parr Rd, Grapevine, TX 76051-5613 | 2014-02-13 |
| 1780865675 | Patricia Ann Irizarry | Nurse Practitioner | 1320 Dublin St, Grapevine, TX 76051-2852 | 2007-11-19 |
| 1215080015 | Jennifer L Rodges | Nurse Practitioner | 670 Westport Pkwy # 5-102, Grapevine, TX 76051-6739 | 2007-01-18 |
| 1518917798 | Trina Desiree Lanza | Nurse Practitioner | 3549 High Timber Dr., Grapevine, TX 76051 | 2006-05-11 |
| 1700887130 | Deanie Spurgin | Nurse Practitioner | 3801 William D Tate Ave Ste 850, Grapevine, TX 76051-8757 | 2005-08-09 |
| Find all providers in GRAPEVINE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.