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MRS. MADELINE MANTILLA M.S.
NPI 1184004335
Counselor - Professional in Stamford, CT

Active since June 03, 2015PECOS Enrolled
401 SHIPPAN AVE, STAMFORD, CT 06902(203) 517-3375(203) 353-1524 Get Directions Write a Review

NPPES record last updated: December 3, 2019. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mrs. Madeline Mantilla M.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. MADELINE MANTILLA M.S. (NPI 1184004335) is an individual professional provider in Stamford, Connecticut, licensed in Connecticut (003667) and active in the NPI registry since June 2015. She is enrolled in Medicare PECOS and maintains a secondary practice location in Bridgeport.

NPPES Registry Identity

NPI1184004335
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMRS. MADELINE MANTILLACredential: M.S.
Location Address401 SHIPPAN AVEStamford, CT 06902-6075
Mailing Address180 Fairfield AveBridgeport, CT 06604-4252 · (203) 394-6529 · Fax (203) 384-8835
Phone(203) 517-3375
Fax(203) 353-1524
Sole ProprietorNo
Enumeration DateJune 3, 2015
Last NPPES UpdateDecember 3, 2019
✔ NPI 1184004335 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in CT · 003667
401 SHIPPAN AVE, Stamford, CT 06902
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Secondary Practice Location 1

Location 1180 Fairfield AveBridgeport, CT 06604-4252 · Phone (203) 394-6529 ext. 3022 · Fax (203) 384-8835

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Madeline Mantilla M.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LUZ CRUZ LCSW
Social Worker
401 SHIPPAN AVE
STAMFORD, CT 06902
Western Connecticut Planning Region (203) 324-6127

Frequently Asked Questions

What is Madeline Mantilla's NPI number?

The NPI number assigned to this healthcare provider is 1184004335, enumerated as an "individual" on June 03, 2015.

Where is the provider located?

The provider is located at 401 SHIPPAN AVE STAMFORD, CT 06902 and the phone number is (203) 517-3375.

What is the provider's specialty?

Counselor with taxonomy code 101YP2500X and a focus in Professional.