Provider Demographics
NPI:1497517510
Name:MANOSALVAS, STEPHANIE (LCSWA)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:MANOSALVAS
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:871 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27605-1499
Mailing Address - Country:US
Mailing Address - Phone:919-229-9834
Mailing Address - Fax:919-747-4269
Practice Address - Street 1:871 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27605
Practice Address - Country:US
Practice Address - Phone:919-229-9834
Practice Address - Fax:919-747-4269
Is Sole Proprietor?:No
Enumeration Date:2024-01-24
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical