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General NPI Number Information
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NPI Number | 1235546169
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Entity Type | Individual
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Provider Name | LACY MAE MENZIES MS MFT LADC, LADC-S
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Gender | Female
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Dates
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Enumeration Date | 07/11/2014
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Last Update Date | 01/05/2024
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Provider Practice Location Address
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Address Line | 151 INDUSTRIAL WAY
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City | FALLON
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State | NV
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Zip | 89406-3116
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Country | US
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Telephone | 177-666-5126
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Fax | 775-294-6015
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Provider Business Mailing Address
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Address Line | 151 INDUSTRIAL WAY
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City | FALLON
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State | NV
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Zip | 89406-3116
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Country | US
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Telephone | 775-666-5126
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 07200-S
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 06600-L
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 4451
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License Number State | NV
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