=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689542193
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LEGACY COUNSELING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/27/2025
-----------------------------------------------------
Last Update Date | 10/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 117 S LEXINGTON ST STE 100
-----------------------------------------------------
City | HARRISONVILLE
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64701-2444
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-607-4929
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 117 S LEXINGTON ST STE 100
-----------------------------------------------------
City | HARRISONVILLE
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64701-2444
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-607-4929
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SUPERVISOR
-----------------------------------------------------
Name | MR. JOSEPH M. LOBUE
-----------------------------------------------------
Credential | LPC
-----------------------------------------------------
Telephone | 816-607-4926
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------