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Individual
JAMES JOSEPH MANCUSO
Active
Individual
JAMES JOSEPH MANCUSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
180.014161
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15074728
CAQH PROVIEW
IL
01
—
180.014161
STATE LICENSE
IL
Enumeration date
01/20/2021
Last updated
11/25/2022
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