Provider Demographics
NPI:1992803365
Name:ERESHENA-MANNING, LYNN CAROL (LCSW)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:CAROL
Last Name:ERESHENA-MANNING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 W TOWN ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:CT
Mailing Address - Zip Code:06249-1536
Mailing Address - Country:US
Mailing Address - Phone:860-642-9018
Mailing Address - Fax:
Practice Address - Street 1:39 W TOWN ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:CT
Practice Address - Zip Code:06249-1536
Practice Address - Country:US
Practice Address - Phone:860-642-9018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical