CRYSTAL MANCO


Address: 530 N Main St, Providence, RI 02904-5762
Phone: 4012742500

CRYSTAL MANCO (NPI# 1891054177) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1891054177
Entity Type Individual
Full Name CRYSTAL MANCO
Credential LCDP
Practice Address 530 N Main St
Providence
RI 02904-5762
Mailing Address 528 N Main St
Providence
RI 02904-5757
Practice Telephone 4012742500
Enumeration Date 2012-05-08
Last Update Date 2015-04-29
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
LCDP00525 RI Behavioral Health & Social Service Providers

Office Location

Street Address 530 N MAIN ST
City PROVIDENCE
State RI
Zip Code 02904-5762

Providers in the same location

NPI Name Taxonomy Address Enumeration
1659379410 Michael Alan Silver Psychiatry & Neurology 530 N Main St, Providence, RI 02904-5762 2005-07-14
1447859954 Melissa Ann Casto Registered Nurse 530 N Main St, Providence, RI 02904-5762 2020-10-26
1972119972 Jessica L Tulli Registered Nurse 530 N Main St, Providence, RI 02904-5762 2020-09-16
1033724554 Jessie Brooks Registered Nurse 530 N Main St, Providence, RI 02904-5762 2020-09-11
1790396935 Mellissa Rose Lacroix Dwyer Social Worker 530 N Main St, Providence, RI 02904-5762 2020-08-12
1184242406 Alyssa Rose Carroll Counselor 530 N Main St, Providence, RI 02904-5762 2020-07-13
1972122364 Katelyn R Agnew Nurse Practitioner 530 N Main St, Providence, RI 02904-5762 2020-04-15
1114555489 Michelle Marie O'rourke Counselor 530 N Main St, Providence, RI 02904-5762 2020-03-31
1639705916 Alice Eyo Registered Nurse 530 N Main St, Providence, RI 02904-5762 2020-03-18
1154954964 Pamela Robinson Counselor 530 N Main St, Providence, RI 02904-5762 2020-02-20
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1144792383 Lifespan Pharmacy LLC Durable Medical Equipment & Medical Supplies 180 Corliss Street, Suite A, Providence, RI 02904 2018-12-28
1780168229 Beth M. Kalunian Social Worker 480 Charles Street, Providence, RI 02904 2018-09-20
1588161608 Michael P. Johnson, Md, Inc Internal Medicine 148 W River St Ste 22b, Providence, RI 02904 2018-04-06
1780045948 Fred Saccoccio Pharmacist 15 Smithfield Road, No Providence, RI 02904 2016-03-16
1699148999 Latin Adult Day Health Care Center Clinic/Center 665 Charles Street, Providence, RI 02904 2015-11-09
1144639956 Dina P Toolin Occupational Therapist 195 Collyer St. 3rd Floor, University Medical Center/miriam Hospital Outpatient, Providence, RI 02904 2014-08-06
1801208798 Seth Clark Internal Medicine 200 Corliss St, Providence, RI 02904 2014-05-27
1134554645 Molly Elizabeth Smith Physical Therapist 1405 Douglas Ave, North Providence, RI 02904 2013-09-04
1336408723 Emad Awa Pediatrics 1 Randall Sq Ste 404, Providence, RI 02904 2012-05-07
1598036790 Joseph F. Osmanski, Od, Inc Optometrist 1971 Mineral Spring Avenue, N. Providence, RI 02904 2012-01-19
Find all providers in zip 02904

Taxonomy Information

Taxonomy Code 101YA0400X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Addiction (Substance Use Disorder)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1477100808 Raisa Emilia Garcia-diaz Counselor 66 Pavilion Avenue, Providence, RI 02905 2019-08-21
1952873317 Better Care Transport LLC Counselor 448 Public St, Providence, RI 02907-1223 2018-12-26
1407234172 David Lee Russell Jr. Counselor 60 Comstock Ave, Providence, RI 02907-1206 2015-05-13
1558755082 Souad Cheteyan Counselor 315 Mount Pleasant Ave, Providence, RI 02908-3836 2015-03-23
1588081533 Nicole Ann Hutto Counselor 20 Vandieman Ave, Providence, RI 02909-5560 2014-03-27
1396050597 Daniel D Strother Counselor 66 Pavilion Ave., Providence, RI 02905 2010-08-11
1902137748 Lux Maria Taylor Counselor 662 Hartford Ave, Providence, RI 02909-5917 2010-01-19
1780805283 Marcel A Trisvan Counselor Codac Providence, 349 Huntington Ave, Providence, RI 02909 2007-05-01
1316063829 Digna Marrero Counselor 16 Borinquen St, 662 Hartford Ave., Providence, RI 02905-3202 2007-03-22
1467554634 George Edward Benedict Counselor Providence Vamc, 830 Chalkstone Avenue, Providence, RI 02908-4799 2006-09-01
Find all providers in PROVIDENCE

Competitor

Search similar providers

City PROVIDENCE
Zip Code 02904

Improve Information

Please comment or provide details below to improve the information on CRYSTAL MANCO.

Dataset Information

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.

Trending Searches