Provider Demographics
NPI:1073874152
Name:MENZIES, JANET SUSAN (MSW, LSWAIC, CDP)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:SUSAN
Last Name:MENZIES
Suffix:
Gender:F
Credentials:MSW, LSWAIC, CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9930 EVERGREEN WAY
Mailing Address - Street 2:SUITE Z150
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-3883
Mailing Address - Country:US
Mailing Address - Phone:425-347-5121
Mailing Address - Fax:425-353-6425
Practice Address - Street 1:9930 EVERGREEN WAY
Practice Address - Street 2:SUITE Z150
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-3883
Practice Address - Country:US
Practice Address - Phone:425-347-5121
Practice Address - Fax:425-353-6425
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP 60132626101YA0400X
WASC 601712061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical