Provider Demographics
NPI:1821010224
Name:FIELDING, MANON (DC, MS, LCAS)
Entity Type:Individual
Prefix:DR
First Name:MANON
Middle Name:
Last Name:FIELDING
Suffix:
Gender:F
Credentials:DC, MS, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 LUPINE CT APT D
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-8123
Mailing Address - Country:US
Mailing Address - Phone:919-758-2268
Mailing Address - Fax:
Practice Address - Street 1:10931 STRICKLAND RD STE 131
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-2085
Practice Address - Country:US
Practice Address - Phone:919-758-2268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-27073101YA0400X
NC2135111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC08448OtherBC/BS
NC7908448Medicaid
NCMEDCOSTOther77310
NC69623Medicare UPIN
NC2449388AMedicare ID - Type Unspecified