Provider Demographics
NPI:1992550347
Name:MAN, JIALE (LMHCA, NCC)
Entity type:Individual
Prefix:DR
First Name:JIALE
Middle Name:
Last Name:MAN
Suffix:
Gender:M
Credentials:LMHCA, NCC
Other - Prefix:DR
Other - First Name:ISAAC
Other - Middle Name:
Other - Last Name:MAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHCA, NCC
Mailing Address - Street 1:2359 FRANKLIN AVE E UNIT 303
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3978
Mailing Address - Country:US
Mailing Address - Phone:443-593-9107
Mailing Address - Fax:
Practice Address - Street 1:2359 FRANKLIN AVE E UNIT 303
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3978
Practice Address - Country:US
Practice Address - Phone:443-593-9107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool