Provider Demographics
NPI:1356180483
Name:MANMADE GROUP LLC
Entity type:Organization
Organization Name:MANMADE GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:HELVEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-MHSP
Authorized Official - Phone:865-281-1830
Mailing Address - Street 1:296 GAMBLE AVE
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37801-4943
Mailing Address - Country:US
Mailing Address - Phone:865-281-1830
Mailing Address - Fax:
Practice Address - Street 1:296 GAMBLE AVE
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37801-4943
Practice Address - Country:US
Practice Address - Phone:865-281-1830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MANMADE GROUP LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-20
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty