Provider Demographics
NPI:1346969953
Name:LEGACY COUNSELING AND CONSULTING SERVICES LLC
Entity Type:Organization
Organization Name:LEGACY COUNSELING AND CONSULTING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:251-406-5886
Mailing Address - Street 1:215 WALNUT ST STE 2
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-5254
Mailing Address - Country:US
Mailing Address - Phone:251-406-5886
Mailing Address - Fax:
Practice Address - Street 1:215 WALNUT ST STE 2
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-5254
Practice Address - Country:US
Practice Address - Phone:251-406-5886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty