MEDICARE: MATTHEW MANLEY MA. LAC. LPC-MH.

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	19091832	SD
2	101YM0800X	Mental Health Counselor	LPC-MH30723	SD

General Provider Information

NPI Number	:	1831971365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW MANLEY MA. LAC. LPC-MH.

Provider Business Mailing Address
First Line	:	906 W 5TH ST
Second Line	:
City	:	CANTON
State	:	SD
Zip	:	57013-1532
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	906 W 5TH ST
Second Line	:
City	:	CANTON
State	:	SD
Zip	:	57013-1532
Country	:	US
Telephone Number	:	715-572-5476
Fax Number	:

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

Provider Enumeration Date	:	10/18/2023
Last Update Date	:	10/18/2023

Similar Medicare Providers

1174831218 — CANTON PHYSICAL MEDICARE, LLC
Practice Location Address:

2050 CUMMING HWY , SUITE 100
CANTON, GA
30114-8614

Practice Phone: 770-345-9600
Practice Fax:

1043102411 — ANNA AMELIA MANLEY LAC
Practice Location Address:

906 W 5TH ST
CANTON, SD
57013-1532

Practice Phone: 605-251-4554
Practice Fax:

1740373752 — OHIO PROSTHETICS & ORTHOTICS LTD
Practice Location Address:

1927 WHIPPLE AVE NW
CANTON, OH
44708-1532

Practice Phone: 330-479-0087
Practice Fax: 330-479-0097

1598181158 — TSJ AGAPECARE INC.
Practice Location Address:

2866 WHIPPLE AVE NW UNIT 4
CANTON, OH
44708-1532

Practice Phone: 330-455-5440
Practice Fax: 330-455-5339

1093264715 — BRITTANY ADAMS
Practice Location Address:

39749 FOX VALLEY DR
CANTON, MI
48188-1532

Practice Phone: 918-361-8797
Practice Fax:

1033823521 — SARAH DUNN CT
Practice Location Address:

2866 WHIPPLE AVE NW
CANTON, OH
44708-1532

Practice Phone: 330-790-1837
Practice Fax:

Directions to “ MATTHEW MANLEY MA. LAC. LPC-MH.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.