Individual provider Active NPI

Pennie Leggett, M.A., L.A.M.F.T.

  • Marriage & Family Therapist
  • Parker, AZ
National Provider Identifier
1306280888
Registry record updated Apr 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LAMFT-10311 Issued in AZ
Practice address
12033 Agency Rd
730
Parker, AZ 85344-7718
Phone
(928) 669-3256
Fax
(928) 669-3252
NPI assigned
Apr 26, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LAMFT-10311 AZ Primary

Addresses

Primary practice location

12033 Agency Rd
730
Parker, AZ 85344-7718

Mailing address

12302 Kennedy Dr
Parker, AZ 85344-9734
Phone (928) 669-3256

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241120000226 TN Practitioner - Marriage and Family Therapist 1153856786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

107 Elmwood Dr
Chattanooga, TN 37411-4209

3228 Brainerd Rd
Chattanooga, TN 37411-3500
Phone (423) 370-3010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LAMFT-10311AZMDMarriage & Family Therapist
1526TNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Pennie Jo Leggett Marriage & Family Therapist CurrentSince Sep 3, 2024 Accepting new patients
Colorado River Indian Tribes PastSince Oct 16, 2022 Accepting new patients
Colorado River Indian Tribes PastSince Oct 16, 2022 Accepting new patients

Locations

3228 Brainerd Rd
Chattanooga, TN 37411
Phone (423) 370-3010

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1366934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366934400000",
    "number": "1306280888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12302 KENNEDY DR",
            "city": "PARKER",
            "state": "AZ",
            "postal_code": "853449734",
            "telephone_number": "928-669-3256",
            "fax_number": "928-669-3252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12033 AGENCY RD",
            "address_2": "730",
            "city": "PARKER",
            "state": "AZ",
            "postal_code": "853447718",
            "telephone_number": "928-669-3256",
            "fax_number": "928-669-3252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGGETT",
        "first_name": "PENNIE",
        "name_prefix": "Ms.",
        "credential": "M.A., L.A.M.F.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-26",
        "last_updated": "2013-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "AZ",
            "license": "LAMFT-10311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parker, AZ

Sources for this page

Verify at the official NPI Registry.