MR. BENNIE JOE MANLEY (NPI# 1740402890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740402890 |
| Entity Type | Individual |
| Full Name | MR. BENNIE JOE MANLEY |
| Credential | MA |
| Practice Address |
3200 Shaler Road Springfield IL 62707 |
| Mailing Address |
2237 Westroad Dr Springfield IL 62711-9630 |
| Practice Telephone | 2175225632 |
| Practice Fax Number | 2175225965 |
| Mailing Telephone | 2175225632 |
| Mailing Fax Number | 2175225965 |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
IL | Behavioral Health & Social Service Providers |
| Street Address |
3200 SHALER ROAD |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730405051 | Bret Lee Miller | Pharmacist | 3250 Clear Lake Ave, Springfield, IL 62707 | 2010-04-12 |
| 1568493336 | Andrea N. Johnson | Counselor | 3270 Moore Rd, Springfield, IL 62707-2515 | 2006-07-06 |
| 1376184820 | Kevin Polk | Marriage & Family Therapist | 350 Bourbon St, Springfield, IL 62707-2702 | 2019-10-07 |
| 1205050192 | Amaretta Marie Gilmer | Speech-Language Pathologist | 4046 Mcconnell Ct, Springfield, IL 62707-3018 | 2007-04-12 |
| 1376766204 | Marcia H. Bunchman | Speech-Language Pathologist | 34 Cabin Smoke Trl, Springfield, IL 62707-4509 | 2007-04-10 |
| 1205027026 | Christie M Davis | Physical Therapist | 51 Frontier Lake Dr, Springfield, IL 62707-7726 | 2007-08-06 |
| 1912975160 | Harold Jay Bruninga | Ophthalmology | 900 Capital Airport Dr, Springfield, IL 62707-8410 | 2006-03-12 |
| 1982044889 | Stouffer Clinical Counseling & Consulting LLC | Community/Behavioral Health | 900 Capital Airport Dr, Springfield, IL 62707-8410 | 2013-06-25 |
| 1407296395 | Kevin R Stouffer | Counselor | 900 Capital Airport Dr, Springfield, IL 62707-8410 | 2013-06-25 |
| 1841810512 | Kathleen Dawn Nicholson-schahl | Occupational Therapist | 920 Estill Dr, Springfield, IL 62707-8561 | 2020-04-22 |
| Find all providers in zip 62707 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578161964 | Joyful Living Behavioral Health Inc | Counselor | 107 W Q St, Springfield, OR 97477-2171 | 2020-10-16 |
| 1366055352 | Joshua Dauner | Counselor | 819 N Boonville Ave, Springfield, MO 65802-3831 | 2020-08-28 |
| 1972114411 | Doris Osiimwe Johnson | Counselor | 52 Elaine Cir # 52, Springfield, MA 01109-1205 | 2020-08-10 |
| 1003426610 | Jy Counseling LLC | Counselor | 6054 Forrest Hollow Ln, Springfield, VA 22152-1428 | 2020-08-07 |
| 1912526674 | Amy Christine Russell | Counselor | 317 30th St Apt 304d, Springfield, OR 97478-7619 | 2020-04-13 |
| 1588299184 | Julie Patricia Slover | Counselor | 3331 S Parkview Ave, Springfield, MO 65804-4755 | 2020-03-04 |
| 1356986319 | Three Dirty Birds LLC | Counselor | 805 Lorraine Dr, Springfield, PA 19064-1004 | 2019-11-14 |
| 1992348916 | Tiffany Looney | Counselor | 1705 Centennial Blvd Ste 1, Springfield, OR 97477-3320 | 2019-10-22 |
| 1588206346 | Carrie Stormzand | Counselor | 4546 S Quail Creek Ave, Springfield, MO 65810-1678 | 2019-10-14 |
| 1366084295 | Betty Jean | Counselor | 673 Morris Ave, Springfield, NJ 07081-1512 | 2019-10-11 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62707 |
Please comment or provide details below to improve the information on MR. BENNIE JOE MANLEY.
| 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.