Jeri Lynne Manhal, M.A., L.P.C., N.C.C.
Individual provider Active NPI Psychoanalyst · Georgetown, TX
NPI 1497071534 · NPPES record last updated Apr 14, 2010
Key facts
- NPI
- 1497071534
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychoanalyst 102L00000X
- License
- 62113 (TX)
- Practice address
- 1618 Williams Dr.
Suite 4
Georgetown, TX 78628 - Phone
- (512) 415-5549
- NPI assigned
- Apr 14, 2010
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 215708 | TX | MD | Counselor |
| 62113 | TX | MD | Psychoanalyst |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 215708 | TX | |
| Psychoanalyst | 102L00000X | 62113 | TX | Yes |
Addresses
Primary practice location
1618 Williams Dr.
Suite 4
Georgetown, TX 78628
Mailing address
1618 Williams Dr.
Suite 4
Georgetown, TX 78628
Phone (512) 415-5549
Other providers in Georgetown, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 14, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.