Provider Demographics
NPI:1275022436
Name:MANGAN, EMILY M (LPC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:M
Last Name:MANGAN
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 1:2002 BREMO RD STE 110
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-2441
Mailing Address - Country:US
Mailing Address - Phone:804-420-2894
Mailing Address - Fax:
Practice Address - Street 1:2002 BREMO RD STE 110
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-2441
Practice Address - Country:US
Practice Address - Phone:804-420-2894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-03
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172V00000X
VA0701014828101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No172V00000XOther Service ProvidersCommunity Health Worker