Active NPI
Legacy Behavioral Health Center, Inc
- Clinical Social Worker
- Vero Beach, FL
National Provider Identifier
1477828887
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Legal business name
- LEGACY BEHAVIORAL HEALTH CENTER, INC
- Practice address
- 1945 22ND Ave
Vero Beach, FL 32960-3083 - Phone
- (772) 646-1682
- Fax
- (772) 257-5265
- NPI assigned
- Mar 19, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Ivan Jimenez
- Title
- Human Resources
- Phone
- (561) 712-8821
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
1945 22ND Ave
Vero Beach, FL 32960-3083
Mailing address
1551 Forum PL
400 D&E
West Palm Beach, FL 33401-2319
National Provider Directory
National Provider DirectoryLocations
1551 Forum Pl
#400
West Palm Beach, FL 33401
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Mental Health Counselor
- Palm Beach Gardens, FL
- NPI 1780013664
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332115200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1332115200000",
"number": "1477828887",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1551 FORUM PL",
"address_2": "400 D&E",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334012319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1945 22ND AVE",
"city": "VERO BEACH",
"state": "FL",
"postal_code": "329603083",
"telephone_number": "772-646-1682",
"fax_number": "772-257-5265"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LEGACY BEHAVIORAL HEALTH CENTER, INC",
"organizational_subpart": "NO",
"enumeration_date": "2012-03-19",
"last_updated": "2012-03-19",
"status": "A",
"authorized_official_last_name": "JIMENEZ",
"authorized_official_first_name": "IVAN",
"authorized_official_title_or_position": "HUMAN RESOURCES",
"authorized_official_telephone_number": "561-712-8821",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Vero Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.