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JACKIE MANIVANH LPC
NPI 1225481146
Counselor - Professional in Fort Worth, TX

Active since July 15, 2016PECOS Enrolled
4516 BOAT CLUB RD STE 106, FORT WORTH, TX 76135(817) 238-0106 Get Directions Write a Review

NPPES record last updated: July 15, 2016. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Jackie Manivanh Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACKIE MANIVANH LPC (NPI 1225481146) is an individual professional provider in Fort Worth, Texas, licensed in Texas (69071) and active in the NPI registry since July 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1225481146
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameJACKIE MANIVANHCredential: LPC
Location Address4516 BOAT CLUB RD STE 106Fort Worth, TX 76135-7020
Mailing Address4516 Boat Club Rd Ste 106Fort Worth, TX 76135-7020 · (817) 238-0106
Phone(817) 238-0106
Sole ProprietorYes
Enumeration DateJuly 15, 2016
✔ NPI 1225481146 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in TX · 69071
4516 BOAT CLUB RD STE 106, Fort Worth, TX 76135
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Baylor Scott and White Health Plan, Blue Cross and Blue Shield of Texas, Oscar Insurance Company and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jackie Manivanh Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GEORGIANA DUNN FAMILY COUNSELOR
Marriage & Family Therapist
4516 BOAT CLUB RD STE 106
FORT WORTH, TX 76135
Tarrant County (817) 238-0106
LAUREN MENDOZA
Counselor (Professional)
4516 BOAT CLUB RD STE 106
FORT WORTH, TX 76135
Tarrant County (817) 238-0106
KAITLIN DEEN MS, LPC
Counselor (Mental Health)
4516 BOAT CLUB RD STE 106
FORT WORTH, TX 76135
Tarrant County (817) 238-0106
TYLER STEVEN BAILEY-BOVILL LPC
Counselor (Professional)
4516 BOAT CLUB RD STE 106
FORT WORTH, TX 76135
Tarrant County (817) 238-0106
CHELSEA RUMSEY
Social Worker (Clinical)
4516 BOAT CLUB RD STE 106
FORT WORTH, TX 76135
Tarrant County (817) 637-2986
JENNIFER CHRISTINE DAVIS LCDC, LPC-A
Counselor (Professional)
4516 BOAT CLUB RD STE 106
FORT WORTH, TX 76135
Tarrant County (817) 238-7473
JACQUELINE JAYDE YOUNG LPC
Counselor (Professional)
4516 BOAT CLUB RD STE 106
FORT WORTH, TX 76135
Tarrant County (817) 238-0106
ELIZABETH VASSEUR
Counselor (Professional)
4516 BOAT CLUB RD STE 106
FORT WORTH, TX 76135
Tarrant County (817) 238-0106

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jackie Manivanh's NPI number?

The NPI number for Jackie Manivanh is 1225481146. It was assigned to this individual provider in the NPPES registry on July 15, 2016.

Where is Jackie Manivanh located?

Jackie Manivanh practices at 4516 Boat Club Rd Ste 106, Fort Worth, TX 76135. The listed phone number is (817) 238-0106.

What is Jackie Manivanh's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Jackie Manivanh enrolled in Medicare?

Yes. Jackie Manivanh is registered in the Medicare PECOS enrollment system.

What insurance does Jackie Manivanh accept?

Health plans from Baylor Scott and White Health Plan, Blue Cross and Blue Shield of Texas, Oscar Insurance Company and UnitedHealthcare list Jackie Manivanh as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jackie Manivanh was last updated on July 15, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.