MEDICARE: MR. PHILIP SCOTT MANNING LPC

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	8331727	ID
2	101YM0800X	Mental Health Counselor	178.021397	IL

General Provider Information

NPI Number	:	1568277283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PHILIP SCOTT MANNING LPC

Provider Business Mailing Address
First Line	:	11901 WINDEMERE CT APT 204
Second Line	:
City	:	ORLAND PARK
State	:	IL
Zip	:	60467-1467
Country	:	US
Telephone Number	:	989-278-6252
Fax Number	:

Provider Business Practice Location Address
First Line	:	7460 W COLLEGE DR STE 101
Second Line	:
City	:	PALOS HEIGHTS
State	:	IL
Zip	:	60463-1193
Country	:	US
Telephone Number	:	888-545-5707
Fax Number	:

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

Provider Enumeration Date	:	02/10/2025
Last Update Date	:	03/10/2025

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