Individual
EMMANUEL CHRISTIAN MANLEY SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCAS-A
Contact information
Practice address
4211 FOUR WINDS CT SW, CONCORD, NC 28027-0413
(803) 371-3172
Mailing address
4211 FOUR WINDS CT SW, CONCORD, NC 28027-0413
(803) 371-3172
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
NC
101YM0800X
Mental Health Counselor
1497095673
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101YM0800X
101YM0800X MENTAL HEALTH
NC
05
—
1497095673
—
NC
Enumeration date
02/25/2013
Last updated
08/30/2013
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