Provider Demographics
NPI:1710028766
Name:MANNING, JILL (PHD, LMFT, CCPS)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:
Last Name:MANNING
Suffix:
Gender:F
Credentials:PHD, LMFT, CCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 MCCASLIN BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-2941
Mailing Address - Country:US
Mailing Address - Phone:720-209-9510
Mailing Address - Fax:720-874-9644
Practice Address - Street 1:357 MCCASLIN BLVD STE 203
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-2941
Practice Address - Country:US
Practice Address - Phone:720-209-9510
Practice Address - Fax:720-874-9644
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-11
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO778106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist