Healthcare Provider Details

I. General information

NPI: 1790235778
Provider Name (Legal Business Name): JANICE LYNN MANN MS, LCAS, LPCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2016
Last Update Date: 09/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 WEDGEFIELD DR
ASHEVILLE NC
28806
US

IV. Provider business mailing address

18 WEDGEFIELD DR
ASHEVILLE NC
28806-2226
US

V. Phone/Fax

Practice location:
  • Phone: 828-252-8748
  • Fax:
Mailing address:
  • Phone: 828-252-8748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCAS-22672
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberA12849
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: