Provider Demographics
NPI:1356862098
Name:MANTER, JASON PAUL
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:PAUL
Last Name:MANTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 WALL ST STE D
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2742
Mailing Address - Country:US
Mailing Address - Phone:513-517-3299
Mailing Address - Fax:513-517-7307
Practice Address - Street 1:2300 WALL ST STE D
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:OH
Practice Address - Zip Code:45212-2742
Practice Address - Country:US
Practice Address - Phone:513-517-3299
Practice Address - Fax:513-517-7307
Is Sole Proprietor?:No
Enumeration Date:2017-07-03
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.2304788-SUPV104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker