Organization Active NPI

Legacy Counseling, LLC

  • Mental Health Counselor
  • Cambridge, MA
National Provider Identifier
1417665480
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
LEGACY COUNSELING, LLC
Practice address
125 Cambridgepark Dr Ste 301
Cambridge, MA 02140-2392
Phone
(857) 392-2234
NPI assigned
Nov 9, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Authorized official

Name
Rosie Labriole
Title
Credentialing Specialist
Phone
(401) 213-4930

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

125 Cambridgepark Dr Ste 301
Cambridge, MA 02140-2392

Mailing address

165 Cambridgepark Dr Unit 217
Cambridge, MA 02140-2486
Phone (857) 392-2234

Other identifiers 1

IdentifierTypeStateIssuer
11304OtherMASTATE OF MASSACHUSETTS LICENSE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1667952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667952000000",
    "number": "1417665480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 CAMBRIDGEPARK DR UNIT 217",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021402486",
            "telephone_number": "857-392-2234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 CAMBRIDGEPARK DR STE 301",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021402392",
            "telephone_number": "857-392-2234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-09",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A",
        "authorized_official_last_name": "LABRIOLE",
        "authorized_official_first_name": "ROSIE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "401-213-4930"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MASSACHUSETTS LICENSE",
            "identifier": "11304",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.