Provider Demographics
NPI:1508161860
Name:JIMENEZ-MANLEY, EMMA (LMHC)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:JIMENEZ-MANLEY
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 1:33701 COUNTY ROAD 52
Mailing Address - Street 2:MC2216
Mailing Address - City:SAINT LEO
Mailing Address - State:FL
Mailing Address - Zip Code:33574-6665
Mailing Address - Country:US
Mailing Address - Phone:352-577-8220
Mailing Address - Fax:
Practice Address - Street 1:33701 COUNTY ROAD 52
Practice Address - Street 2:
Practice Address - City:SAINT LEO
Practice Address - State:FL
Practice Address - Zip Code:33574
Practice Address - Country:US
Practice Address - Phone:352-588-7203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-18
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH 8245101YM0800X
FLMH11481101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health