Provider Demographics
NPI:1265300115
Name:MANSKY, BRIAN KENNETH (LMSW)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:KENNETH
Last Name:MANSKY
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:PO BOX 113
Mailing Address - Street 2:
Mailing Address - City:GARRETT PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20896-0113
Mailing Address - Country:US
Mailing Address - Phone:301-651-4275
Mailing Address - Fax:301-231-0124
Practice Address - Street 1:10605 CONCORD ST STE 207
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-2526
Practice Address - Country:US
Practice Address - Phone:301-651-4275
Practice Address - Fax:301-231-0124
Is Sole Proprietor?:No
Enumeration Date:2025-10-23
Last Update Date:2025-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25434104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker