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General NPI Number Information
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NPI Number | 1669337374
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Entity Type | Organization
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Legal Business Name | ILEGACY CONSULTING AND COUNSELING, PLLC
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Dates
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Enumeration Date | 12/16/2025
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 1311 ROSEBROOK DR
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City | MANSFIELD
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State | TX
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Zip | 76063-7503
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Country | US
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Telephone | 817-372-0353
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Fax | 817-585-4064
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Provider Business Mailing Address
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Address Line | 1311 ROSEBROOK DR
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City | MANSFIELD
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State | TX
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Zip | 76063-7503
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Country | US
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Telephone | 817-372-0353
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Fax | 817-585-4064
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Authorized Official
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Title or Position | OWNER/CLINICIAN
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Name | LACHELLE GRACE GOODRICH
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Credential | LPC-S
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Telephone | 817-372-0353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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