MEDICARE: MANHATTAN MENTAL HEALTH SERVICES, LLC

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
1	103TC0700X	Clinical Psychologist	1990	KS
2	103TC0700X	Clinical Psychologist	2069	KS

General Provider Information

NPI Number	:	1043645781
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MANHATTAN MENTAL HEALTH SERVICES, LLC

Provider Business Mailing Address
First Line	:	555 POYNTZ AVE
Second Line	:	SUITE 243
City	:	MANHATTAN
State	:	KS
Zip	:	66502-0107
Country	:	US
Telephone Number	:	785-537-6051
Fax Number	:	844-222-3691

Provider Business Practice Location Address
First Line	:	555 POYNTZ AVE STE 243
Second Line	:
City	:	MANHATTAN
State	:	KS
Zip	:	66502-0129
Country	:	US
Telephone Number	:	785-537-6051
Fax Number	:	844-222-3691

Authorized Official
Title or Position	:	LICENSED PSYCHOLOGIST
Name	:	CHAZ D MAILEY
Credential	:
Telephone Number	:	785-537-6051

Provider Enumeration Date	:	09/12/2013
Last Update Date	:	12/09/2025

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