Provider Demographics
NPI:1780576223
Name:LEGACY THERAPY LLC.
Entity type:Organization
Organization Name:LEGACY THERAPY LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICENSED MARRIAGE/FAMILY THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:DIPASTENA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMFT
Authorized Official - Phone:423-544-0199
Mailing Address - Street 1:525 HUNT CLIFF DR NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37311-1642
Mailing Address - Country:US
Mailing Address - Phone:423-544-0199
Mailing Address - Fax:423-544-0199
Practice Address - Street 1:525 HUNT CLIFF DR NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311-1642
Practice Address - Country:US
Practice Address - Phone:423-544-0199
Practice Address - Fax:423-544-0199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-18
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health