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General NPI Number Information
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NPI Number | 1053270892
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Entity Type | Organization
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Legal Business Name | LEGACY COACHING AND COUNSELING LLC
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Dates
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Enumeration Date | 01/19/2026
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Last Update Date | 01/19/2026
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Provider Practice Location Address
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Address Line | 2330 ROCKLYN DR
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City | URBANDALE
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State | IA
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Zip | 50322-4935
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Country | US
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Telephone | 404-896-7417
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Fax | 515-513-3153
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Provider Business Mailing Address
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Address Line | 14708 HORTON AVE
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City | URBANDALE
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State | IA
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Zip | 50323-2471
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Country | US
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Telephone | 515-480-1641
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Fax |
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Authorized Official
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Title or Position | CEO & THERAPIST
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Name | KIMBERLEE GREGORY
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Credential | LISW
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Telephone | 515-480-1641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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