MEDICARE: MRS. YULAN MELISSA MENZIE-HACKNEY LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor		CT
2	101YP2500X	Professional Counselor	8342	CT

General Provider Information

NPI Number	:	1174217350
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. YULAN MELISSA MENZIE-HACKNEY LPC

Provider Business Mailing Address
First Line	:	42 DEAN PL APT 106A
Second Line	:
City	:	BRIDGEPORT
State	:	CT
Zip	:	06610-1655
Country	:	US
Telephone Number	:	203-572-6057
Fax Number	:

Provider Business Practice Location Address
First Line	:	42 DEAN PL APT 106A
Second Line	:
City	:	BRIDGEPORT
State	:	CT
Zip	:	06610-1655
Country	:	US
Telephone Number	:	203-572-6057
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2023
Last Update Date	:	03/02/2026

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