Provider Demographics
NPI:1295329464
Name:MANNING, STEPHANIE LOUISE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:LOUISE
Last Name:MANNING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:STEPHANIE
Other - Middle Name:LOUISE
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:102 GIBSON RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16125-9764
Mailing Address - Country:US
Mailing Address - Phone:757-771-9278
Mailing Address - Fax:
Practice Address - Street 1:240 W 11TH ST STE 105
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16501-1758
Practice Address - Country:US
Practice Address - Phone:814-453-7955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-26
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX642421041C0700X
PACW0224991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical