Provider Demographics
NPI:1548348949
Name:MANWARING, JANIS O (LICSW, LADC, LCS)
Entity type:Individual
Prefix:
First Name:JANIS
Middle Name:O
Last Name:MANWARING
Suffix:
Gender:F
Credentials:LICSW, LADC, LCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 ROXBURY ST
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-3816
Mailing Address - Country:US
Mailing Address - Phone:603-358-5035
Mailing Address - Fax:603-352-7924
Practice Address - Street 1:106 ROXBURY ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-3816
Practice Address - Country:US
Practice Address - Phone:603-358-5035
Practice Address - Fax:603-352-7924
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0313101YA0400X
NH26101YP2500X
NH10841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical