Provider Demographics
NPI:1861859498
Name:PERSUTTE MANNING, STEPHANIE LEIGH (MA MFT)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LEIGH
Last Name:PERSUTTE MANNING
Suffix:
Gender:F
Credentials:MA MFT
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:LEIGH
Other - Last Name:PERSUTTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8791 WOLFF CT
Mailing Address - Street 2:SUITE 140
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-3600
Mailing Address - Country:US
Mailing Address - Phone:720-443-2276
Mailing Address - Fax:
Practice Address - Street 1:8791 WOLFF CT
Practice Address - Street 2:SUITE 140
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-3600
Practice Address - Country:US
Practice Address - Phone:720-443-2276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-27
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional