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

Individual provider Clinical Social Worker · NPI 1649459835

Mr. Theb Manivanh, LCSW is a Clinical Social Worker in Visalia, California. Qualified in 2000, 26 years ago. Practices with Lake County Tribal Health Consortium Inc, a 42-clinician group and works from 2 locations. Licensed in California.

Years since qualifying
26
Licensed in
CA
In the registry since
2007
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

505 N Court St
Visalia, CA 93291-4912
Phone: (559) 730-7566
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 925 Bevins Ct, Lakeport, CA 95453-9754 — (707) 263-8382

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 28251 (CA)

Record details

NPI number1649459835
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorNo
NPI enumeratedOctober 24, 2007
Last updated in NPPESAugust 4, 2025
Certification dateAugust 4, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice Lake County Tribal Health Consortium Inc — 42 clinicians
Accepts Medicare assignment Not indicated

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