Provider Demographics
NPI:1831109685
Name:MANLEY, CECELIA HOPE (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:CECELIA
Middle Name:HOPE
Last Name:MANLEY
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 BRANFORD RD UNIT 346
Mailing Address - Street 2:
Mailing Address - City:NORTH BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06471-1373
Mailing Address - Country:US
Mailing Address - Phone:203-334-2814
Mailing Address - Fax:
Practice Address - Street 1:250 W MAIN ST STE 303
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-4032
Practice Address - Country:US
Practice Address - Phone:203-334-2814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT240001235CT01101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT240001235CT 01OtherANTHEM PROVIDER ID