Provider Demographics
NPI:1851155618
Name:LEGACY MENTAL HEALTH CONSULTING SERVICES
Entity Type:Organization
Organization Name:LEGACY MENTAL HEALTH CONSULTING SERVICES
Other - Org Name:LEGACY MENTAL HEALTH CONSULTING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OUTPATIENT THERAPIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:LARUTH
Authorized Official - Last Name:YANCEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:757-319-2758
Mailing Address - Street 1:3413 MARLA CT
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-1261
Mailing Address - Country:US
Mailing Address - Phone:757-319-2758
Mailing Address - Fax:
Practice Address - Street 1:3413 MARLA CT
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23323-1261
Practice Address - Country:US
Practice Address - Phone:757-319-2758
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty