Provider Demographics
NPI:1124379565
Name:MONA MANNING, LCSW PC
Entity Type:Organization
Organization Name:MONA MANNING, LCSW PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MONA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANNNING
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:847-772-7260
Mailing Address - Street 1:3013 MARY KAY LN
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-1162
Mailing Address - Country:US
Mailing Address - Phone:847-772-7260
Mailing Address - Fax:
Practice Address - Street 1:3013 MARY KAY LN
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-1162
Practice Address - Country:US
Practice Address - Phone:847-772-7260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-25
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490151881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty