Provider Demographics
NPI:1982849352
Name:MANUEL, JAMES WESLEY (PSYD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WESLEY
Last Name:MANUEL
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 SPRING LAKE PKWY
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-5593
Mailing Address - Country:US
Mailing Address - Phone:937-329-1298
Mailing Address - Fax:817-394-5075
Practice Address - Street 1:120 W 2ND ST STE 400
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-1602
Practice Address - Country:US
Practice Address - Phone:937-329-1298
Practice Address - Fax:817-394-5075
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-12
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7170103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist