Provider Demographics
NPI:1154931210
Name:MANNING, DAVID L (LMHC- MH18227)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:L
Last Name:MANNING
Suffix:
Gender:M
Credentials:LMHC- MH18227
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3907 N FEDERAL HWY # 271
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-6042
Mailing Address - Country:US
Mailing Address - Phone:954-254-6389
Mailing Address - Fax:
Practice Address - Street 1:4311 CRYSTAL LAKE DR
Practice Address - Street 2:203
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-3306
Practice Address - Country:US
Practice Address - Phone:954-254-6389
Practice Address - Fax:954-245-2710
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-04
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH18227101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty