Provider Demographics
NPI:1396515474
Name:LEGACY COUNSELING
Entity type:Organization
Organization Name:LEGACY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/LMFT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:585-201-8463
Mailing Address - Street 1:70 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-1468
Mailing Address - Country:US
Mailing Address - Phone:585-201-8463
Mailing Address - Fax:
Practice Address - Street 1:70 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-1468
Practice Address - Country:US
Practice Address - Phone:585-201-8463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty