Provider Demographics
NPI:1336241355
Name:MANES, HARRY F (MSW)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:F
Last Name:MANES
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 711
Mailing Address - Street 2:
Mailing Address - City:HAZELWOOD
Mailing Address - State:NC
Mailing Address - Zip Code:28738
Mailing Address - Country:US
Mailing Address - Phone:828-456-1977
Mailing Address - Fax:828-456-1892
Practice Address - Street 1:1648 S MAIN
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786
Practice Address - Country:US
Practice Address - Phone:828-456-1977
Practice Address - Fax:828-456-1892
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC612104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6002142Medicaid
NC6002142Medicaid