Provider Demographics
NPI:1679098933
Name:MANZIONE, CHEYANNE MARSHALL (MSW)
Entity Type:Individual
Prefix:
First Name:CHEYANNE
Middle Name:MARSHALL
Last Name:MANZIONE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:CHEYANNE
Other - Middle Name:ELIZBETH
Other - Last Name:MARSHALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3227 UMBRELLA TREE DR
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:FL
Mailing Address - Zip Code:32141-6518
Mailing Address - Country:US
Mailing Address - Phone:386-864-2601
Mailing Address - Fax:
Practice Address - Street 1:3227 UMBRELLA TREE DR
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:FL
Practice Address - Zip Code:32141-6518
Practice Address - Country:US
Practice Address - Phone:386-864-2601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-08
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
FL17499104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor