Organization Active NPI

Legacy Therapy LLC.

  • Community/Behavioral Health Agency
  • Cleveland, TN
National Provider Identifier
1780576223
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
LEGACY THERAPY LLC.
Practice address
525 Hunt Cliff Dr NW
Cleveland, TN 37311-1642
Phone
(423) 544-0199
Fax
(423) 544-0199
NPI assigned
Jul 18, 2025
Last updated
Jul 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Authorized official

Name
Dr. Andrew William Dipastena, PHD, LMFTNPI 1003577370
Title
Licensed Marriage/Family Therapist
Phone
(423) 544-0199

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
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

525 Hunt Cliff Dr NW
Cleveland, TN 37311-1642

Mailing address

525 Hunt Cliff Dr NW
Cleveland, TN 37311-1642
Phone (423) 544-0199

Other practice location 1

335 11th St NE
Cleveland, TN 37311-5187
Phone (423) 476-5513

Other practice location 2

2200 Chambliss Ave NW
Cleveland, TN 37311-3874
Phone (423) 599-9347

Other names 1

  • Legacy Therapy LLC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251023000388 TN Part B Supplier - Clinic/Group Practice 2466940218 Receives reassigned benefits from 1 practitioner
Practice locations: Cleveland, TN

National Provider Directory

National Provider Directory

Locations

335 11th St NE
Cleveland, TN 37311
Phone (423) 458-2584

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1752796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753228800000",
    "number": "1780576223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 HUNT CLIFF DR NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373111642",
            "telephone_number": "423-544-0199",
            "fax_number": "423-544-0199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 HUNT CLIFF DR NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373111642",
            "telephone_number": "423-544-0199",
            "fax_number": "423-544-0199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "335 11th St NE",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "TN",
            "postal_code": "373115187",
            "country_code": "US",
            "telephone_number": "423-476-5513",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Chambliss Ave NW",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "TN",
            "postal_code": "373113874",
            "country_code": "US",
            "telephone_number": "423-599-9347",
            "fax_number": "832-369-7679",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LEGACY THERAPY LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-18",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A",
        "authorized_official_last_name": "DIPASTENA",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "LICENSED MARRIAGE/FAMILY THERAPIST",
        "authorized_official_telephone_number": "423-544-0199",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LMFT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Therapy LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Legacy Therapy LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Cleveland, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.