Provider Demographics
NPI:1669749883
Name:MANWARING, AMI KENDRA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:AMI
Middle Name:KENDRA
Last Name:MANWARING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12250 SAN ANTONIO RD
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-6201
Mailing Address - Country:US
Mailing Address - Phone:805-234-2382
Mailing Address - Fax:
Practice Address - Street 1:7305 MORRO RD STE 206
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-4445
Practice Address - Country:US
Practice Address - Phone:805-234-2382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-17
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA250391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health