Provider Demographics
NPI:1689181786
Name:LEGG-GRADY, SVEN LAILER (EDS, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:SVEN
Middle Name:LAILER
Last Name:LEGG-GRADY
Suffix:
Gender:M
Credentials:EDS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3688 GAINESVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:BLAIRSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30512-6503
Mailing Address - Country:US
Mailing Address - Phone:706-250-0415
Mailing Address - Fax:706-487-8498
Practice Address - Street 1:3688 GAINESVILLE HWY
Practice Address - Street 2:
Practice Address - City:BLAIRSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30512-6503
Practice Address - Country:US
Practice Address - Phone:706-250-0415
Practice Address - Fax:706-487-8498
Is Sole Proprietor?:No
Enumeration Date:2018-01-10
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional