Legacy Human Services, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

200100176 Issued in NC

Legal business name

LEGACY HUMAN SERVICES, INC.

Practice address

630 S Garnett St
Henderson, NC 27536-4509

Phone

(252) 492-8699

Fax

(252) 492-1172

NPI assigned

Mar 5, 2007

Last updated

Sep 10, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lynn Fleming

Title

Finance Director

Phone

(252) 492-8699

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Legacy Human Services, Inc.

  • Community/Behavioral Health Agency
  • Henderson, NC
  • NPI 1700998143

  O20050217000870

  Same enrollment

Locations

Practitioners 4

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.

• Benjamin Joseph Mastridge, MSN, PMHAPRN-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Youngsville, NC
  • NPI 1942421508
  Medicare reassignment NPD
• Charles Thomas Browning Sr., MD

  • Psychiatry Physician
  • Cary, NC
  • NPI 1568672905
  Medicare reassignment
• Kimberly McCowan, LPCA

  • Mental Health Counselor
  • Henderson, NC
  • NPI 1831544683
  NPD (past)
• Jeremy Stolfi, LCAS

  • Addiction (Substance Use Disorder) Counselor
  • Henderson, NC
  • NPI 1831553064
  NPD (past)

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631232000000",
    "number": "1881723096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 88",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275360088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 S GARNETT ST",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275364509",
            "telephone_number": "252-492-8699",
            "fax_number": "252-492-1172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY HUMAN SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A",
        "authorized_official_last_name": "FLEMING",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "252-492-8699"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "200100176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5900366",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Legacy Human Services, Inc.
• Legacy Human Services, Inc.
• Legacy Human Services, Inc.
• Legacy Human Services, Inc.
• Legacy Human Services, Inc.
• Legacy Human Services, Inc.
• Legacy Human Services, Inc.
• Paula M Leif, CRNP
• Rebecca Sky Leonard
• Rhonda R Lewis-Brown, PHD COUNSELING

• Community/Behavioral Health Agency in Henderson, NC
• Providers in Henderson, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.