Individual
PHILIP MANILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
3701 LANDSDOWNE DR, ASHLAND, KY 41102-5422
(606) 324-3005
(606) 329-1530
Mailing address
PO BOX 790, ASHLAND, KY 41105-0790
(606) 329-8588
(606) 329-8195
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
102962
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000286533
ANTHEM BCBS
—
01
—
000516911
UNITED BEHAVIORAL HEALTH
—
01
—
11738942
CAQH
—
01
—
610661987
LIFESYNCH
—
05
—
710281010
—
KY
01
—
APPROVED
CIGNA
—
Enumeration date
09/16/2006
Last updated
02/07/2019
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