Provider Demographics
NPI:1760946958
Name:MANNING, JAMIE HOPE (LMSW)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:HOPE
Last Name:MANNING
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 SQUADRON BLVD STE 320
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-5260
Mailing Address - Country:US
Mailing Address - Phone:917-597-9270
Mailing Address - Fax:
Practice Address - Street 1:20 SQUADRON BLVD
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-5200
Practice Address - Country:US
Practice Address - Phone:917-597-9270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-22
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04-7078-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker