Provider Demographics
NPI:1407326721
Name:MANNING, MARTHA LOUIS (LPC)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:LOUIS
Last Name:MANNING
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:LOUIS
Other - Last Name:ZUNIGA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:3901 BRIGHT AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29205-4601
Mailing Address - Country:US
Mailing Address - Phone:803-530-6935
Mailing Address - Fax:
Practice Address - Street 1:1 WINDSOR CV STE 301
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-1833
Practice Address - Country:US
Practice Address - Phone:803-530-6935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-29
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7169101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional