Active NPI
Dennis Charles Legendre, LISW-S, LICDC-CS
- Clinical Social Worker
- Dayton, OH
National Provider Identifier
1013201581
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I 08152
- Practice address
- 4100 W. Third Street
Dayton VA Medical Center
Dayton, OH 45428 - Phone
- (513) 673-2564
- NPI assigned
- Jun 2, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 82790 | OH | |
| Clinical Social Worker | 1041C0700X | I 08152 | OH | Primary |
Addresses
Primary practice location
4100 W. Third Street
Dayton VA Medical Center
Dayton, OH 45428
Mailing address
4100 W 3Rd St
Building 409, Room 123
Dayton, OH 45428-9000
Phone (937) 268-6511
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 82790 | OH | MD | Addiction (Substance Use Disorder) Counselor |
| I 08152 | OH | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490659200000",
"number": "1013201581",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4100 W 3RD ST",
"address_2": "BUILDING 409, ROOM 123",
"city": "DAYTON",
"state": "OH",
"postal_code": "454289000",
"telephone_number": "937-268-6511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 W. THIRD STREET",
"address_2": "DAYTON VA MEDICAL CENTER",
"city": "DAYTON",
"state": "OH",
"postal_code": "45428",
"telephone_number": "513-673-2564"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEGENDRE",
"first_name": "DENNIS",
"middle_name": "CHARLES",
"credential": "LISW-S, LICDC-CS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-02",
"last_updated": "2017-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "82790",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "I 08152",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.