Provider Demographics
NPI:1225514292
Name:MENZIE, EMMA JACQUELINE (LMFT)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:JACQUELINE
Last Name:MENZIE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:EMMA
Other - Middle Name:
Other - Last Name:BRODGINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5540 FALMOUTH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-1800
Mailing Address - Country:US
Mailing Address - Phone:804-665-4681
Mailing Address - Fax:
Practice Address - Street 1:5540 FALMOUTH ST STE 100
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-1800
Practice Address - Country:US
Practice Address - Phone:804-665-4681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-12
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CAAMFT184133106H00000X
VA0717001831106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health