Individual
MS. JERI MICHELE MANKYE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC, LCADCAS
Contact information
Practice address
814 RADNOR AVE, BALTIMORE, MD 21212
(443) 540-1191
Mailing address
814 RADNOR AVE, BALTIMORE, MD 21212
(443) 540-1191
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
AC2198
MD
101YA0400X
Addiction (Substance Use Disorder) Counselor
LC8326
MD
101YM0800X
Mental Health Counselor
Primary
LC8326
MD
101YP2500X
Professional Counselor
LC8326
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265486740
NATIONAL PROVIDER NUMBER
MD
05
—
818032601
—
MD
Enumeration date
03/23/2018
Last updated
09/25/2019
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