Im Legacy Counseling & Consultation Services, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

IM LEGACY COUNSELING & CONSULTATION SERVICES, LLC

Doing business as

I.M. Legacy Counseling & Consultation Services, LLC

Practice address

3562 Piedmont Rd NE Apt 305
Atlanta, GA 30305-7003

Phone

(614) 206-4452

NPI assigned

Apr 16, 2022

Organization subpart

No

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

Authorized official

Name

Miss Vaya Milan Fraley, LISWNPI 1457845232

Title

Co-Founder

Phone

(614) 706-1899

Specialties & licenses 1

Addresses

Other names 1

• I.M. Legacy Counseling & Consultation 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.

• Vaya Milan Fraley, LISW

  • Social Worker
  • Columbus, OH
  • NPI 1457845232
  NPD Authorized official

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

{
    "created_epoch": "1650067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650067200000",
    "number": "1609519701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 EASTON MARKET UNIT 1201",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432196023",
            "telephone_number": "614-706-1899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3562 PIEDMONT RD NE APT 305",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303057003",
            "telephone_number": "614-206-4452"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6220 Harmon Glen Ln",
            "address_purpose": "LOCATION",
            "city": "Canal Winchester",
            "state": "OH",
            "postal_code": "431108086",
            "country_code": "US",
            "telephone_number": "614-206-4452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IM LEGACY COUNSELING & CONSULTATION SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-16",
        "last_updated": "2022-04-16",
        "certification_date": "2022-04-16",
        "status": "A",
        "authorized_official_last_name": "FRALEY",
        "authorized_official_first_name": "VAYA",
        "authorized_official_middle_name": "MILAN",
        "authorized_official_title_or_position": "CO-FOUNDER",
        "authorized_official_telephone_number": "614-706-1899",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LISW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "I.M. Legacy Counseling & Consultation Services, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Zachary Nicholas Illg
• Elizabeth Illien
• Humza Ilyas, M.D.
• Yasamin Alwan Ilyas, D.O.
• Rosa Ilyayeva
• Chae Won Im, MD
• Imagine Gynecology LLC
• Imagine New Beginnings LLC
• Imagine Orthodontics, LLC
• Imaging Group Center Inc

• Clinical Social Worker in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.