Provider Demographics
NPI:1285746909
Name:MANUSZAK, MICHELLE C (LPCMH)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:C
Last Name:MANUSZAK
Suffix:
Gender:F
Credentials:LPCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1151 WALKER RD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-6600
Mailing Address - Country:US
Mailing Address - Phone:302-674-2380
Mailing Address - Fax:302-674-1299
Practice Address - Street 1:1151 WALKER RD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-6600
Practice Address - Country:US
Practice Address - Phone:302-674-2380
Practice Address - Fax:302-674-1299
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000198101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health