MEDICARE: KASEY MANWARING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	APC001379	PA

General Provider Information

NPI Number	:	1265321467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KASEY MANWARING

Provider Business Mailing Address
First Line	:	110 LEVERING ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19127-1404
Country	:	US
Telephone Number	:	610-457-5424
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 LEVERING ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19127-1404
Country	:	US
Telephone Number	:	610-457-5424
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2025
Last Update Date	:	07/01/2025

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Directions to “ KASEY MANWARING ” Practice Location

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