Provider Demographics
NPI:1043645781
Name:MANHATTAN MENTAL HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:MANHATTAN MENTAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:CHAZ
Authorized Official - Middle Name:D
Authorized Official - Last Name:MAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-537-6051
Mailing Address - Street 1:555 POYNTZ AVE
Mailing Address - Street 2:SUITE 243
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-0107
Mailing Address - Country:US
Mailing Address - Phone:785-537-6051
Mailing Address - Fax:844-222-3691
Practice Address - Street 1:555 POYNTZ AVE STE 243
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-0129
Practice Address - Country:US
Practice Address - Phone:785-537-6051
Practice Address - Fax:844-222-3691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-12
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1990103TC0700X
KS2069103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty