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NPI Code Detail

MEDICARE: LEGACY COUNSELING AND CONSULTING SERVICES, LLC

MEDICARE: LEGACY COUNSELING AND CONSULTING SERVICES, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1235772617
Entity Type Code : Organization
Provider Name (Legal Business Name) : LEGACY COUNSELING AND CONSULTING SERVICES, LLC
Provider Business Mailing Address
First Line : PO BOX 32892
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63132-8892
Country : US
Telephone Number : 314-328-1757
Fax Number : 855-582-1697
Provider Business Practice Location Address
First Line : 201 S SKINKER BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63105-2317
Country : US
Telephone Number : 314-485-9330
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DAWN JONES
Credential : MAC
Telephone Number : 314-328-1757
Provider Enumeration Date : 10/18/2019
Last Update Date : 04/08/2025

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Directions to “LEGACY COUNSELING AND CONSULTING SERVICES, LLC ” Practice Location

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