Organization Active NPI

Legendary Connections Therapeutic Services, LLC

  • Community/Behavioral Health Agency
  • Augusta, GA
National Provider Identifier
1811346265
Registry record updated Jun 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
LPC005565 Issued in GA
Legal business name
LEGENDARY CONNECTIONS THERAPEUTIC SERVICES, LLC
Practice address
1227 Augusta West Pkwy
Suite 3
Augusta, GA 30909-6670
Phone
(706) 432-1584
NPI assigned
Jun 7, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2016

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

Authorized official

Name
Latonya Cowan Patterson, LPC
Title
Owner
Phone
(706) 399-6284

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X LPC005565 GA Primary

Addresses

Primary practice location

1227 Augusta West Pkwy
Suite 3
Augusta, GA 30909-6670

Mailing address

1227 Augusta West Pkwy
Suite 3
Augusta, GA 30909-6670
Phone (706) 432-1584

National Provider Directory

National Provider Directory

Locations

1227 Augusta West Pkwy
Ste 3
Augusta, GA 30909
Phone (706) 432-1584

NPI Registry JSON

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465257600000",
    "number": "1811346265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1227 AUGUSTA WEST PKWY",
            "address_2": "SUITE 3",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096670",
            "telephone_number": "706-432-1584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 AUGUSTA WEST PKWY",
            "address_2": "SUITE 3",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096670",
            "telephone_number": "706-432-1584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGENDARY CONNECTIONS THERAPEUTIC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-07",
        "last_updated": "2016-06-07",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "LATONYA",
        "authorized_official_middle_name": "COWAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-399-6284",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "LPC005565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; 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.