Provider Demographics
NPI:1659537009
Name:MANN, JASABEL RAMIREZ (MA, LMHC, CEAP)
Entity Type:Individual
Prefix:MS
First Name:JASABEL
Middle Name:RAMIREZ
Last Name:MANN
Suffix:
Gender:F
Credentials:MA, LMHC, CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 290921
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33687-0921
Mailing Address - Country:US
Mailing Address - Phone:813-967-2176
Mailing Address - Fax:813-443-5266
Practice Address - Street 1:6601 MEMORIAL HIGHWAY SUITE 108
Practice Address - Street 2:SUITE E
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615
Practice Address - Country:US
Practice Address - Phone:813-967-2176
Practice Address - Fax:813-443-5266
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-05
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH-4842101YM0800X
FLMH4842103K00000X, 101YM0800X
VACEAP/SAP 0044403101YA0400X
CEAP0044403101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH-4842OtherMENTAL HEALTH COUNSELING
FL002696600Medicaid