Mr. George Michael Mantas
Clinical Psychologist Addiction Psychologist (Substance Use Disorder)
1001 Military St
Port Huron
, Michigan 48060-5416
Mr. George Michael Mantas
Clinical Psychologist Addiction Psychologist (Substance Use Disorder)
1001 Military St
Port Huron
, Michigan 48060-5416
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About
Features
Specialties
- Addiction Psychologist (Substance Use Disorder)
- Clinical Psychologist
Languages spoken
- English
Location
First Address
- Mr. George Michael Mantas
- 5360 Smiths Creek Rd
- Kimball, MI
- Zip : 48074-3807
- Phone :
Second Address
- Mr. George Michael Mantas
- 1001 Military St
- Port Huron, MI
- Zip : 48060-5416
- Fax : (810) 985-9011
- Phone : (810) 985-5168
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FAQs
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Is Mr. George Michael Mantas a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 6301010808 | MI |
| Y | 103G00000X | Clinical Psychologist | 6301010808 | MI |
| Y | 103TC0700X | Clinical Psychologist | 6301010808 | MI |
National Provider Identifier
| NPI | 1316040256 |
|---|---|
| Provider Name | Mr. George Michael Mantas |
| First Address | Kimball, MI 48074-3807 |
| Second Address | Port Huron, MI 48060-5416 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/09/2006 |
| Last Update Date | 11/09/2008 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.