NPIMap

Organization Active NPI

Legacy Clinical Consultants

  • Mental Health Counselor
  • Lisle, IL
National Provider Identifier
1497823900
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
LEGACY CLINICAL CONSULTANTS
Practice address
3033 Ogden Ave
Suite 210
Lisle, IL 60532-1673
Phone
(630) 527-1664
NPI assigned
Dec 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Anne FrentzosNPI 1508082348
Title
Licensed Clinical Professional Coun
Phone
(630) 527-1664

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

3033 Ogden Ave
Suite 210
Lisle, IL 60532-1673

Mailing address

3033 Ogden Ave
Suite 210
Lisle, IL 60532-1673

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497823900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 OGDEN AVE",
            "address_2": "SUITE 210",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 OGDEN AVE",
            "address_2": "SUITE 210",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321673",
            "telephone_number": "630-527-1664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY CLINICAL CONSULTANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FRENTZOS",
        "authorized_official_first_name": "ANNE",
        "authorized_official_title_or_position": "LICENSED CLINICAL PROFESSIONAL COUN",
        "authorized_official_telephone_number": "630-527-1664"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.