NPIMap

Organization Active NPI

Legacy Family Services, LLC

  • Professional Counselor
  • Glenn Dale, MD
National Provider Identifier
1770180838
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
LEGACY FAMILY SERVICES, LLC
Practice address
11415 Old Pond Dr
Glenn Dale, MD 20769-9154
Phone
(301) 200-2919
NPI assigned
Oct 1, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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

Authorized official

Name
Angela T Dudley Hamilton, LCPCNPI 1881957934
Title
Owner
Phone
(202) 746-4345

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
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

11415 Old Pond Dr
Glenn Dale, MD 20769-9154

Mailing address

11415 Old Pond Dr
Glenn Dale, MD 20769-9154

Other identifiers 1

IdentifierTypeStateIssuer
EM58-0000OtherCAREFIRST

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address whatalegacy@hushmail.com

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1601510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601510400000",
    "number": "1770180838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11415 OLD POND DR",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11415 OLD POND DR",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699154",
            "telephone_number": "301-200-2919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY FAMILY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-01",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A",
        "authorized_official_last_name": "DUDLEY HAMILTON",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "202-746-4345",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "EM58-0000",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "whatalegacy@hushmail.com",
            "affiliation": "N",
            "endpointDescription": "Email Address",
            "address_1": "11415 Old Pond Dr",
            "city": "Glenn Dale",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207699154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glenn Dale, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.