Provider Demographics
NPI:1144603523
Name:MANWARRING, PEYTON K (MED,LPC,NCC)
Entity Type:Individual
Prefix:MS
First Name:PEYTON
Middle Name:K
Last Name:MANWARRING
Suffix:
Gender:F
Credentials:MED,LPC,NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 PARKWOODS AVE
Mailing Address - Street 2:
Mailing Address - City:KIRKWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63122-4655
Mailing Address - Country:US
Mailing Address - Phone:314-550-5265
Mailing Address - Fax:
Practice Address - Street 1:533 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:WEBSTER GROVES
Practice Address - State:MO
Practice Address - Zip Code:63119-1860
Practice Address - Country:US
Practice Address - Phone:314-550-5265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-03
Last Update Date:2016-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012003618101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional