Provider Demographics
NPI:1174656813
Name:MANNING, KEVIN F (LMHC, LRC)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:F
Last Name:MANNING
Suffix:
Gender:M
Credentials:LMHC, LRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-3617
Mailing Address - Country:US
Mailing Address - Phone:508-222-4388
Mailing Address - Fax:508-222-4388
Practice Address - Street 1:45 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-3617
Practice Address - Country:US
Practice Address - Phone:508-222-4388
Practice Address - Fax:508-222-4388
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1990101YM0800X
MA806101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional