Provider Demographics
NPI:1568618411
Name:MCMANUS, MICHAEL JAMES JR (MSW LICSW)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JAMES
Last Name:MCMANUS
Suffix:JR
Gender:M
Credentials:MSW LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 CURTIS HILL RD
Mailing Address - Street 2:
Mailing Address - City:CHARLTON
Mailing Address - State:MA
Mailing Address - Zip Code:01507-1282
Mailing Address - Country:US
Mailing Address - Phone:508-450-2296
Mailing Address - Fax:
Practice Address - Street 1:191 CITY DEPOT RD
Practice Address - Street 2:SUITE 102
Practice Address - City:CHARLTON
Practice Address - State:MA
Practice Address - Zip Code:01507-5445
Practice Address - Country:US
Practice Address - Phone:508-450-2296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA441119101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health