Legacy Counseling Services LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

LEGACY COUNSELING SERVICES LLC

Doing business as

Legacy Counseling Services LLC

Practice address

622 Windbrook Cir
Newport News, VA 23602-8847

Phone

(804) 677-0223

NPI assigned

Jul 17, 2020

Last updated

Jul 17, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Ebony NickensNPI 1417817974

Title

Owner

Phone

(804) 677-0223

Specialties & licenses 2

Addresses

Other names 1

• Legacy Counseling Services LLC Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ebony Brooke Nickens

  • Home Health Aide
  • Hayes, VA
  • NPI 1417817974
  NPD Authorized official

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

{
    "created_epoch": "1594944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594944000000",
    "number": "1427666106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 WINDBROOK CIR",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236028847",
            "telephone_number": "804-677-0223",
            "fax_number": "804-210-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 WINDBROOK CIR",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236028847",
            "telephone_number": "804-677-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-17",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A",
        "authorized_official_last_name": "NICKENS",
        "authorized_official_first_name": "EBONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-677-0223",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Counseling Services LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stgeorge Tucker Lee, M.D.
• Terrelle Lee, CNA
• Timothy Robert Lee, RN, BSN, MSN, FNP-BC
• Wolfgang Leesch, M.D.
• Cody Leeworthy, DPT
• Derek Mitchell Leggett, RN
• Legit Transport LLC (Legit Transport)
• Janel S Legore
• Lawrence Gene Leichtman, MD
• John C Leist III, DMD MS

• Adolescent and Children Mental Health Clinic/Center in Newport News, VA
• Providers in Newport News, VA by specialty
• Adolescent and Children Mental Health Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2020; 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.