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General NPI Number Information
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NPI Number | 1154122414
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Entity Type | Organization
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Legal Business Name | LEGACY HEALING SERVICES, LLC
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Dates
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Enumeration Date | 03/22/2025
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Last Update Date | 03/22/2025
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Provider Practice Location Address
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Address Line | 2154 SEVEN SPRINGS BLVD
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City | NEW PRT RCHY
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State | FL
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Zip | 34655-3910
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Country | US
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Telephone | 727-473-6815
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Fax |
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Provider Business Mailing Address
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Address Line | 8441 RUSTLEWOOD CT
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City | TRINITY
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State | FL
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Zip | 34655-4578
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMANDA MERSKI
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Credential | LCSW
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Telephone | 727-473-6815
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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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