Healthcare Provider Details

I. General information

NPI: 1083985998
Provider Name (Legal Business Name): STEPHEN LAWRENCE MANEY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2012
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 BERCUT DR STE C
SACRAMENTO CA
95811-0110
US

IV. Provider business mailing address

3841 N FREEWAY BLVD STE 245
SACRAMENTO CA
95834-1969
US

V. Phone/Fax

Practice location:
  • Phone: 916-363-1553
  • Fax:
Mailing address:
  • Phone: 916-441-0226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number78482
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW78482
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: