MEDICARE: ASHLEY MANASSE-GRIFFIN LMHC

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1417313537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY MANASSE-GRIFFIN LMHC

Provider Business Mailing Address
First Line	:	2740 SW MARTIN DOWNS BLVD # 433
Second Line	:
City	:	PALM CITY
State	:	FL
Zip	:	34990-6046
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2740 SW MARTIN DOWNS BLVD # 433
Second Line	:
City	:	PALM CITY
State	:	FL
Zip	:	34990-6046
Country	:	US
Telephone Number	:	845-536-1398
Fax Number	:

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

Provider Enumeration Date	:	01/05/2016
Last Update Date	:	02/15/2022

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