Provider Demographics
NPI:1467826149
Name:MANNING, MICHELE (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:
Last Name:MANNING
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MS
Other - First Name:MICHELE
Other - Middle Name:
Other - Last Name:MANNING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCPC
Mailing Address - Street 1:PO BOX 1713
Mailing Address - Street 2:171 HARLOW RD
Mailing Address - City:THOMPSON FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59873
Mailing Address - Country:US
Mailing Address - Phone:406-827-5591
Mailing Address - Fax:406-847-4242
Practice Address - Street 1:171 HARLOW RD
Practice Address - Street 2:
Practice Address - City:THOMASON FALLS
Practice Address - State:MT
Practice Address - Zip Code:59873
Practice Address - Country:US
Practice Address - Phone:406-847-5850
Practice Address - Fax:406-847-4242
Is Sole Proprietor?:No
Enumeration Date:2015-11-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTSWP-LCPC-LIC-9294101Y00000X
MTBBH-LCPC-LIC9294101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional