Provider Demographics
NPI:1821635889
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:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:ALDEN
Authorized Official - Last Name:DOSS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:702-763-7443
Mailing Address - Street 1:6600 W CHARLESTON BLVD STE 111
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-1067
Mailing Address - Country:US
Mailing Address - Phone:702-763-7443
Mailing Address - Fax:702-763-7443
Practice Address - Street 1:6600 W CHARLESTON BLVD STE 111
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-1067
Practice Address - Country:US
Practice Address - Phone:702-763-7443
Practice Address - Fax:702-763-7443
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEGACY COUNSELING AND WORKFORCE CONNECTIONS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-09
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)