Provider Demographics
NPI:1609565480
Name:MCMANUS, KAMI (MS, MFT, PSYD)
Entity Type:Individual
Prefix:DR
First Name:KAMI
Middle Name:
Last Name:MCMANUS
Suffix:
Gender:F
Credentials:MS, MFT, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3624 MARKET ST STE 201
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-2614
Mailing Address - Country:US
Mailing Address - Phone:215-662-7772
Mailing Address - Fax:215-615-3671
Practice Address - Street 1:3624 MARKET ST STE 201
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-2614
Practice Address - Country:US
Practice Address - Phone:800-789-7366
Practice Address - Fax:215-615-3671
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-05
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TH0004X, 103TH0100X
PAPS019881173F00000X, 103TC0700X
PA019881103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No173F00000XOther Service ProvidersSleep Specialist, PhD