Provider Demographics
NPI:1326331273
Name:MANIACE, BEVERLY LOUISE (CASAC, NCAC 1)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:LOUISE
Last Name:MANIACE
Suffix:
Gender:F
Credentials:CASAC, NCAC 1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 ELLICOTT ST
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-3650
Mailing Address - Country:US
Mailing Address - Phone:585-815-0247
Mailing Address - Fax:
Practice Address - Street 1:314 ELLICOTT ST
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-3650
Practice Address - Country:US
Practice Address - Phone:585-815-0247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)