Provider Demographics
NPI:1679318968
Name:MANZER, EMILY ELIZABETH (LCSW-A, LCAS-A)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ELIZABETH
Last Name:MANZER
Suffix:
Gender:F
Credentials:LCSW-A, LCAS-A
Other - Prefix:
Other - First Name:EMMETT
Other - Middle Name:
Other - Last Name:MANZER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW-A, LCAS-A
Mailing Address - Street 1:2206 WRIGHTSVILLE AVE STE A
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-2406
Mailing Address - Country:US
Mailing Address - Phone:910-763-6499
Mailing Address - Fax:
Practice Address - Street 1:2206 WRIGHTSVILLE AVE STE A
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-2406
Practice Address - Country:US
Practice Address - Phone:910-763-6499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-27
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-29853101YA0400X
NCP0208441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)