Provider Demographics
NPI:1104302579
Name:LISA P. MCMANUS, MS, LPC
Entity type:Organization
Organization Name:LISA P. MCMANUS, MS, LPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMANUS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:251-202-5655
Mailing Address - Street 1:PO BOX 62
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:AL
Mailing Address - Zip Code:36559-0062
Mailing Address - Country:US
Mailing Address - Phone:251-202-5655
Mailing Address - Fax:251-202-5707
Practice Address - Street 1:25369 US HIGHWAY 98 STE C
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-4864
Practice Address - Country:US
Practice Address - Phone:251-202-5655
Practice Address - Fax:251-202-5707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-18
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1506101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty