Active NPI
Jeffery Ray Manzer, MED
- Mental Health Counselor
- Beaumont, TX
National Provider Identifier
1144791963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 79252
- Practice address
- 3350 Dowlen Rd Suite J
Beaumont, TX 77707 - Phone
- (409) 813-1116
- NPI assigned
- Dec 6, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 79252 | TX | Primary |
Addresses
Primary practice location
3350 Dowlen Rd Suite J
Beaumont, TX 77707
Mailing address
5434 Oakwood Dr
Kountze, TX 77625-7197
Phone (409) 782-0291
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 79252 | TX | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544054400000",
"number": "1144791963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5434 OAKWOOD DR",
"city": "KOUNTZE",
"state": "TX",
"postal_code": "776257197",
"telephone_number": "409-782-0291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3350 DOWLEN RD SUITE J",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "77707",
"telephone_number": "409-813-1116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANZER",
"first_name": "JEFFERY",
"middle_name": "RAY",
"name_prefix": "Mr.",
"credential": "MED",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-12-06",
"last_updated": "2018-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "79252",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaumont, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.