Provider Demographics
NPI:1760027213
Name:LEGACY COUNSELING AND WORKFORCE CONNECTIONS
Entity Type:Organization
Organization Name:LEGACY COUNSELING AND WORKFORCE CONNECTIONS
Other - Org Name:LEGACY COUNSELING AND WORKFORCE CONNECTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:DOSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-763-7443
Mailing Address - Street 1:4170 S DECATUR BLVD STE 9
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-5861
Mailing Address - Country:US
Mailing Address - Phone:702-763-7443
Mailing Address - Fax:866-284-1860
Practice Address - Street 1:4170 S DECATUR BLVD STE 9
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-5861
Practice Address - Country:US
Practice Address - Phone:702-763-7443
Practice Address - Fax:866-284-1860
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEGACY COUNSELING AND WORKFORCE CONNECTIONS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-11-07
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty