Provider Demographics
NPI:1659905743
Name:NEW LEGACY COUNSELING, AZ, PLLC
Entity Type:Organization
Organization Name:NEW LEGACY COUNSELING, AZ, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:HELTERBRAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:480-737-6138
Mailing Address - Street 1:22511 S 202ND ST
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-6259
Mailing Address - Country:US
Mailing Address - Phone:480-737-6138
Mailing Address - Fax:
Practice Address - Street 1:1206 E WARNER RD STE 118
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-3133
Practice Address - Country:US
Practice Address - Phone:480-712-6242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty