DR. MICHAEL JAY MANALO (NPI# 1679857171) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679857171 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL JAY MANALO |
| Credential | PH.D. |
| Practice Address |
45 South Ave Se Ste 100 Marietta GA 30060-2539 |
| Practice Telephone | 7704237500 |
| Practice Fax Number | 6789090294 |
| Mailing Telephone | 7704237500 |
| Mailing Fax Number | 6789090294 |
| Enumeration Date | 2011-10-03 |
| Last Update Date | 2012-09-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC1900X |
Psychologist Specialization: Counseling |
PSY003588 | GA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912973819 | Michael J Manalo | Anesthesiology | 615 S New Ballas Rd Dept Of, Saint Louis, MO 63141-8221 | 2006-02-28 |
| Street Address |
45 SOUTH AVE SE STE 100 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30060-2539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144845116 | Legacy Center for Spinal Surgery, LLC | Neurological Surgery | 1900 The Exchange, Ne, Suite 600, Marietta, GA 30060 | 2020-06-15 |
| 1407477193 | Michael Cynil Daniel | Counselor | 698 N Marietta, Pkwy, Marietta, GA 30060 | 2020-05-04 |
| 1285253401 | Cameron Thomas Kennelly | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne Attn:gme, Marietta, GA 30060 | 2020-04-09 |
| 1922640739 | Jeremiah George Blair | Physician Assistant | 61 Whitcher St Suite 2100, Marietta, GA 30060 | 2019-10-14 |
| 1164064945 | Denise Alicia Mick | Registered Nurse | 677 Church St Wellstar Kennestone Hospital, Marietta, GA 30060 | 2019-10-12 |
| 1184283772 | Iora Health Georgia, P.C. | Internal Medicine | 280 Cobb Pkwy Se, Suite 60, Marietta, GA 30060 | 2019-06-07 |
| 1346703212 | Caitlin Virginia Mueller | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne, Attn: Gme, Marietta, GA 30060 | 2019-04-08 |
| 1184187205 | Adero Francis | Student in an Organized Health Care Education/Training Program | Wellstar Kennestone Gme Internal Medicine Clinic, 833 Campbell Hill St Nw, Suite 250, Marietta, GA 30060 | 2019-04-08 |
| 1659832749 | Matthew Mozzo | Student in an Organized Health Care Education/Training Program | 677 Church Street / Lower Level, Gme Department / I.m., Marietta, GA 30060 | 2019-03-29 |
| 1245797430 | La'myia Spentz | Specialist | 109 Anderson St Ne, Suite 608, Marietta, GA 30060 | 2019-02-25 |
| Find all providers in zip 30060 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871100024 | Life Skills Community Center Inc | Psychologist | 2440 Sandy Plains Rd Ste 300, Marietta, GA 30066-7217 | 2020-09-30 |
| 1376173658 | Marcuetta D. Sims | Psychologist | 2436 Wood Meadows Dr Sw, Marietta, GA 30064-4471 | 2020-01-25 |
| 1043740772 | John Acomb | Psychologist | 4743 Carmichael Chase Ne, Marietta, GA 30066-1473 | 2017-06-15 |
| 1447303524 | Sheri Michelle Siegel | Psychologist | 125 Church St Ne, Suite 210, Marietta, GA 30060-8638 | 2007-01-19 |
| 1699859876 | Nancy Ellen Reigle | Psychologist | 2627 Sandy Plains Rd, Suite 101, Marietta, GA 30066-4269 | 2006-10-25 |
| 1639264120 | Linda Pak Bruner | Psychologist | 1640 Powers Ferry Road Se, Building 9, Suite 100, The Anxiety & Stress Management Institute, Marietta, GA 30067-5491 | 2006-10-03 |
| 1306134564 | Tonette Robinson | Psychologist | 55 Whitcher St Ne Ste 420, Marietta, GA 30060-1171 | 2011-07-20 |
| 1710034723 | Christine K Beard | Psychologist | 2655 Dallas Hwy Sw, Suite 230, Marietta, GA 30064-2597 | 2007-01-04 |
| 1487742052 | Rebecca Andrea Beaton | Psychologist | 1640 Powers Ferry Rd Se, Building 9, Suite 100, Marietta, GA 30067-5491 | 2006-10-10 |
| 1588676654 | Susan Leslie Mayo | Psychologist | 1640 Powers Ferry Rd Se, Bldg. 17, Ste. 350, Marietta, GA 30067-5491 | 2006-08-13 |
| Find all providers in MARIETTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.