Provider Demographics
NPI:1134587470
Name:MANERS, LISA A (LPC-MHSP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:A
Last Name:MANERS
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 MADISON AVE # 2113
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-2620
Mailing Address - Country:US
Mailing Address - Phone:901-264-9722
Mailing Address - Fax:901-347-1277
Practice Address - Street 1:3383 JOFFERE AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38111
Practice Address - Country:US
Practice Address - Phone:901-264-9722
Practice Address - Fax:901-347-1277
Is Sole Proprietor?:No
Enumeration Date:2016-02-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3548101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional