Provider Demographics
NPI:1366774788
Name:MANWARREN, JAYNE LURINDA (LPC)
Entity type:Individual
Prefix:MRS
First Name:JAYNE
Middle Name:LURINDA
Last Name:MANWARREN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:JAYNIE
Other - Middle Name:LURINDA
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21731 TIMBERLAKE RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-7400
Mailing Address - Country:US
Mailing Address - Phone:434-455-5033
Mailing Address - Fax:434-455-5034
Practice Address - Street 1:21731 TIMBERLAKE RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-7400
Practice Address - Country:US
Practice Address - Phone:434-455-5033
Practice Address - Fax:434-455-5034
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004778101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health