Provider Demographics
NPI:1114263498
Name:LEGATSKI AND ASSOCIATES
Entity Type:Organization
Organization Name:LEGATSKI AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MAX
Authorized Official - Middle Name:W
Authorized Official - Last Name:LEGATSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:918-336-6401
Mailing Address - Street 1:300 E 14TH ST
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74003-5907
Mailing Address - Country:US
Mailing Address - Phone:918-336-6401
Mailing Address - Fax:918-336-2401
Practice Address - Street 1:520 E 6TH ST.
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74003
Practice Address - Country:US
Practice Address - Phone:918-336-2400
Practice Address - Fax:918-336-2401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-14
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK641106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty