MEDICARE: MR. JUSTIN HARRISON MCMANUS LCSW

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	1041C0700X	Clinical Social Worker	SW8168	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083755391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JUSTIN HARRISON MCMANUS LCSW

Provider Business Mailing Address
First Line	:	1201 US 1
Second Line	:	SUITE 225
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-3550
Country	:	US
Telephone Number	:	561-459-0621
Fax Number	:	561-290-1803

Provider Business Practice Location Address
First Line	:	1201 US 1
Second Line	:	SUITE 225
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-3550
Country	:	US
Telephone Number	:	561-459-0621
Fax Number	:	561-290-1803

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2007
Last Update Date	:	05/09/2015

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