Provider Demographics
NPI:1821597162
Name:MANISCALCO, CHRISTOPHER (LCSW)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:MANISCALCO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4414 FUSCHIA CIR N
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-5425
Mailing Address - Country:US
Mailing Address - Phone:561-865-6889
Mailing Address - Fax:
Practice Address - Street 1:471 SPENCER DR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-3675
Practice Address - Country:US
Practice Address - Phone:561-873-2122
Practice Address - Fax:561-805-3690
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-01
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN102821041C0700X
FLSW196541041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical