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General NPI Number Information
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NPI Number | 1720787393
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Entity Type | Organization
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Legal Business Name | LEGACY COUNSELING AND WELLNESS SERVICES, LLC
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Dates
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Enumeration Date | 03/02/2023
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Last Update Date | 03/02/2023
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Provider Practice Location Address
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Address Line | 1800 GERMAN SCHOOL RD
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City | RICHMOND
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State | VA
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Zip | 23225-4184
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Country | US
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Telephone | 804-426-3859
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 GERMAN SCHOOL RD
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City | RICHMOND
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State | VA
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Zip | 23225-4184
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Country | US
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Telephone | 804-426-3859
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Fax |
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Authorized Official
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Title or Position | OWNER/EXECUTIVE DIRECTOR
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Name | MRS. FELICIA ALLEN MASON
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Credential | LPC
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Telephone | 804-426-3859
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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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