Provider Demographics
NPI:1952765984
Name:MCMANNES, JAMIE (LCSW)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:MCMANNES
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 1:801 GREEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-7021
Mailing Address - Country:US
Mailing Address - Phone:336-832-4777
Mailing Address - Fax:336-832-4779
Practice Address - Street 1:801 GREEN VALLEY RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7021
Practice Address - Country:US
Practice Address - Phone:336-832-4777
Practice Address - Fax:336-832-4779
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0115111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical