Provider Demographics
NPI:1104400662
Name:LENOIR, MARIELLE MANZANO (MED, LPC)
Entity Type:Individual
Prefix:MRS
First Name:MARIELLE
Middle Name:MANZANO
Last Name:LENOIR
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:MARIELLE
Other - Middle Name:MICHELLE
Other - Last Name:MANZANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, LPC
Mailing Address - Street 1:5085 W PARK BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-2000
Mailing Address - Country:US
Mailing Address - Phone:972-665-8484
Mailing Address - Fax:469-409-4557
Practice Address - Street 1:5085 W PARK BLVD STE 200
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-2000
Practice Address - Country:US
Practice Address - Phone:972-665-8484
Practice Address - Fax:469-409-4557
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81087101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional