Organization
MANIFESTING EXCELLENCE LLC
Active
Other names
MELLC
Organization subpart
No
Provider details
NPI number
Authorized official
LISA ANN CRAWLEY-MCGHEE LICDC-CS (OWNER/ CEO)
(614) 626-8464
Entity
Organization
Contact information
Practice address
6100 CHANNINGWAY BLVD, SUITE 605, COLUMBUS, OH 43232-2910
(614) 694-0990
Mailing address
6100 CHANNINGWAY BLVD, SUITE 605, COLUMBUS, OH 43232-2910
(614) 626-8464
(614) 626-8809
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
964511
OH
251S00000X
Community/Behavioral Health Agency
Primary
964511
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0174232
—
OH
Enumeration date
03/08/2017
Last updated
04/28/2023
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