Timothy James Legg, PHD, PSYD, CRNP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS019448 Issued in PA

Practice address

421 S State St
Clarks Summit, PA 18411-1684

Phone

(570) 682-5777

Fax

(570) 284-3078

NPI assigned

Jul 31, 2006

Last updated

Nov 12, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in PA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Group practices

Ars Treatment Centers PCGroup PAC ID 0042568131, 107 clinicians

Matthew a Berger MD PCGroup PAC ID 5991791212, 51 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: timothyl@berger.medentdirect.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ars Treatment Centers, P.C.

  • Multi-Specialty Clinic/Center
  • Uniontown, PA
  • NPI 1346731171
  Medicare reassignment Care Compare group NPD
• Legg Counseling & Consulting Services, LLC

  • Clinical Psychologist
  • Clarks Summit, PA
  • NPI 1285202895
  Medicare reassignment NPD Authorized official
• Matthew a Berger MD PC

  • Physician Assistant
  • Moosic, PA
  • NPI 1275617508
  Medicare reassignment Care Compare group
• Ars Treatment Centers, P.C.

  dba Crossroads Treatment Centers Beaver (LAB)

  • Clinical Medical Laboratory
  • Beaver, PA
  • NPI 1992370324
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1063427417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 S STATE ST",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184111684",
            "telephone_number": "570-682-5777",
            "fax_number": "570-284-3078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 S STATE ST",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184111684",
            "telephone_number": "570-682-5777",
            "fax_number": "570-284-3078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGG",
        "first_name": "TIMOTHY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "PHD, PSYD, CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP-006515-H",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP013800",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS019448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Anthony Langan, DDS
• Lasting Wellness LLC
• Lisa Ann Layne, M.A.
• Susan C Lee, M.D.
• Legg Counseling & Consulting Services, LLC
• Erica Marie Lepito, LCSW
• Susan D Levin, MA, LPC, NCC, CCMHC
• Caitlin Libby, DDS
• Timothy Lionetti, PH.D.
• John Lisiak Jr., D.O.

• Clinical Psychologist in Clarks Summit, PA
• Providers in Clarks Summit, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.