Provider Demographics
NPI:1225232457
Name:ACQUIRE THE LEGACY COUNSELING
Entity Type:Organization
Organization Name:ACQUIRE THE LEGACY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:E
Authorized Official - Last Name:JAMES WESLEY
Authorized Official - Suffix:
Authorized Official - Credentials:CCC, SW,PC,
Authorized Official - Phone:609-233-7652
Mailing Address - Street 1:PO BOX 1150
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08362-1150
Mailing Address - Country:US
Mailing Address - Phone:609-233-7652
Mailing Address - Fax:
Practice Address - Street 1:717 E LANDIS AVE
Practice Address - Street 2:STE., 5
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-8000
Practice Address - Country:US
Practice Address - Phone:609-233-7652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
NJ104100000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty