Provider Demographics
NPI:1821235607
Name:MANNING, ANNE ELIZABETH (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:ELIZABETH
Last Name:MANNING
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:ELIZABETH
Other - Last Name:DZERKACZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LMHC
Mailing Address - Street 1:9 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:MAYNARD
Mailing Address - State:MA
Mailing Address - Zip Code:01754-1331
Mailing Address - Country:US
Mailing Address - Phone:978-897-2576
Mailing Address - Fax:978-897-2576
Practice Address - Street 1:9 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:MAYNARD
Practice Address - State:MA
Practice Address - Zip Code:01754-1331
Practice Address - Country:US
Practice Address - Phone:978-897-2576
Practice Address - Fax:978-897-2576
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-15
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA840101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health