MEDICARE: JEANNE MANNINO MA, LMHC

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	000395	NY
2	101YP2500X	Professional Counselor	000395	NY
3	103TB0200X	Cognitive & Behavioral Psychologist	000395	NY
4	101Y00000X	Counselor	000395	NY

General Provider Information

NPI Number	:	1619095650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANNE MANNINO MA, LMHC

Provider Business Mailing Address
First Line	:	471 BAY RIDGE PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-2701
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	471 BAY RIDGE PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-2701
Country	:	US
Telephone Number	:	718-748-5825
Fax Number	:

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

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	09/11/2025

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