Provider Demographics
NPI:1174217350
Name:MENZIE-HACKNEY, YULAN MELISSA (LPC)
Entity type:Individual
Prefix:MRS
First Name:YULAN
Middle Name:MELISSA
Last Name:MENZIE-HACKNEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 DEAN PL APT 106A
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06610-1655
Mailing Address - Country:US
Mailing Address - Phone:203-572-6057
Mailing Address - Fax:
Practice Address - Street 1:9 MOTT AVE FL 4
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06850-3330
Practice Address - Country:US
Practice Address - Phone:203-523-5738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-08
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT101YM0800X
CT8342101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health