Healthcare Provider Details

I. General information

NPI: 1720339112
Provider Name (Legal Business Name): CARRIE L MANY LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2012
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3815 W ST JOE ST STE B301
LANSING MI
48917-5606
US

IV. Provider business mailing address

6240 TOWAR AVE
EAST LANSING MI
48823-1554
US

V. Phone/Fax

Practice location:
  • Phone: 517-410-9494
  • Fax:
Mailing address:
  • Phone: 517-410-9494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401012087
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: