Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Individual
MR. MANUEL F CARRILLO
Active
Individual
MR. MANUEL F CARRILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1580
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12362523
CAQH UNIVERSAL PROVIDER DATASOURCE
—
Enumeration date
08/07/2007
Last updated
09/17/2012
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