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NPI Code Detail

MEDICARE: STACEY ARLEEN MANLEY

MEDICARE:   STACEY ARLEEN MANLEY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1881272706
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACEY ARLEEN MANLEY
Provider Business Mailing Address
First Line : 818 SEMINOLE DR
Second Line :
City : SUFFOLK
State : VA
Zip : 23434-4131
Country : US
Telephone Number : 757-334-0773
Fax Number : 757-809-5797
Provider Business Practice Location Address
First Line : 818 SEMINOLE DR
Second Line :
City : SUFFOLK
State : VA
Zip : 23434-4131
Country : US
Telephone Number : 757-334-0773
Fax Number : 757-809-5797
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2021
Last Update Date : 03/31/2021

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Directions to “ STACEY ARLEEN MANLEY ” Practice Location

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