Provider Demographics
NPI:1265538615
Name:MANNING, JAMIE (LPC)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:
Last Name:MANNING
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:18203 OLIVE TREE COURT
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429
Mailing Address - Country:US
Mailing Address - Phone:713-259-5103
Mailing Address - Fax:
Practice Address - Street 1:18203 OLIVE TREE COURT
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429
Practice Address - Country:US
Practice Address - Phone:713-259-5103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18795101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXBLUE CROSS/BLUE SHIEOther6492LC
TXJTAYLOR684OtherCIGNA
TX7755598OtherAETNA