Provider Demographics
NPI:1215275839
Name:MANEESE, TABITHA S (LPCC)
Entity type:Individual
Prefix:
First Name:TABITHA
Middle Name:S
Last Name:MANEESE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 COUNTY ROAD 2000
Mailing Address - Street 2:
Mailing Address - City:JEROMESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44840-9758
Mailing Address - Country:US
Mailing Address - Phone:419-289-4325
Mailing Address - Fax:419-289-4826
Practice Address - Street 1:304 COUNTY ROAD 2000
Practice Address - Street 2:
Practice Address - City:JEROMESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44840-9758
Practice Address - Country:US
Practice Address - Phone:419-289-4325
Practice Address - Fax:413-289-4826
Is Sole Proprietor?:No
Enumeration Date:2013-01-17
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE. 1100189101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health