Provider Demographics
NPI:1487202537
Name:MANROSS, LINDA JEAN (LMHC)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:JEAN
Last Name:MANROSS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1439 BUFFALO ST
Mailing Address - Street 2:
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760-1140
Mailing Address - Country:US
Mailing Address - Phone:716-375-4740
Mailing Address - Fax:716-375-4752
Practice Address - Street 1:1439 BUFFALO ST
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-1140
Practice Address - Country:US
Practice Address - Phone:716-375-4740
Practice Address - Fax:716-375-4752
Is Sole Proprietor?:No
Enumeration Date:2019-09-03
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
006390101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health