Provider Demographics
NPI:1225845373
Name:MANEWITH, JAMIE KAREN (MSW, LSW)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:KAREN
Last Name:MANEWITH
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 ARBOR VITAE RD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-2875
Mailing Address - Country:US
Mailing Address - Phone:847-951-2064
Mailing Address - Fax:
Practice Address - Street 1:799 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-5637
Practice Address - Country:US
Practice Address - Phone:224-998-4766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-12
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150114695104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker