Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jackie Manivanh, LPC

Individual provider Professional Counselor · NPI 1225481146

Jackie Manivanh, LPC is a Professional Counselor in Fort Worth, Texas. Practices as a sole proprietor. Licensed in Texas.

Licensed in
TX
In the registry since
2016
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

4516 Boat Club Rd Ste 106
Fort Worth, TX 76135-7020
Phone: (817) 238-0106
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 69071 (TX)

Record details

NPI number1225481146
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPC
Sole proprietorYes
NPI enumeratedJuly 15, 2016
Last updated in NPPESJuly 15, 2016

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