Provider Demographics
NPI:1003230046
Name:MANUEL, AMELEO D (MA LPCA NCC)
Entity Type:Individual
Prefix:
First Name:AMELEO
Middle Name:D
Last Name:MANUEL
Suffix:
Gender:M
Credentials:MA LPCA NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3146 ARDEN WAY
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-6170
Mailing Address - Country:US
Mailing Address - Phone:704-675-0259
Mailing Address - Fax:770-818-5753
Practice Address - Street 1:4566 LAWRENCEVILLE HWY NW STE 101
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047
Practice Address - Country:US
Practice Address - Phone:770-217-7563
Practice Address - Fax:770-818-5753
Is Sole Proprietor?:No
Enumeration Date:2014-02-11
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor