MEDICARE: LEGACY FAMILY COUNSELING AND CONSULTING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor		TX

General Provider Information

NPI Number	:	1124148150
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEGACY FAMILY COUNSELING AND CONSULTING

Provider Business Mailing Address
First Line	:	1400 PRESTON RD
Second Line	:	SUITE 400
City	:	PLANO
State	:	TX
Zip	:	75093-5186
Country	:	US
Telephone Number	:	972-665-9758
Fax Number	:	214-291-5443

Provider Business Practice Location Address
First Line	:	1400 PRESTON RD
Second Line	:	STE 400
City	:	PLANO
State	:	TX
Zip	:	75093-5186
Country	:	US
Telephone Number	:	972-665-9758
Fax Number	:	214-291-5443

Authorized Official
Title or Position	:	CO-OWNER
Name	:	MR. BRENT J DUNN
Credential	:	LMFT, LPC
Telephone Number	:	972-665-9758

Provider Enumeration Date	:	03/31/2007
Last Update Date	:	02/26/2009

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Directions to “LEGACY FAMILY COUNSELING AND CONSULTING ” Practice Location

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