Provider Demographics
NPI:1134838881
Name:MCMANUS, JAMES MACAULAY (LMSW)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:MACAULAY
Last Name:MCMANUS
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 22ND ST # 3
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-2934
Mailing Address - Country:US
Mailing Address - Phone:518-505-0534
Mailing Address - Fax:
Practice Address - Street 1:2550 22ND ST # 3
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-2934
Practice Address - Country:US
Practice Address - Phone:518-505-0534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-22
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY118147104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker