Provider Demographics
NPI:1497451363
Name:MANN, JOAN L (MA, LPC)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:L
Last Name:MANN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 MAHOOD TRCE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25705-2601
Mailing Address - Country:US
Mailing Address - Phone:540-815-9084
Mailing Address - Fax:
Practice Address - Street 1:1303 WASHINGTON ST W
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25302-1333
Practice Address - Country:US
Practice Address - Phone:540-815-9084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor