LEGACY LIFE CARE PROGRAMS NPI 1962746842

NPI Information

NPI: 1962746842
Provider Name: LEGACY LIFE CARE PROGRAMS

Other Name: LEGACY LIFE CARE PROGRAMS-BRENTWOOD

Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

Address:
1661 MALLORY LN
BRENTWOOD, TN
ZIP 37027
Phone: (931) 626-1644
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LEGACY LIFE CARE PROGRAMS is a professional counselor in Brentwood, TN. LEGACY LIFE CARE PROGRAMS NPI is 1962746842. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Legacy Life Care Programs-brentwood.

The provider's business location address is:

1661 MALLORY LN
BRENTWOOD, TN
ZIP 37027-931
Phone: (931) 626-1644
Fax: (931) 381-5363

The provider's authorized official is Linda R Smith .
The authorized official title is Ceo/president and has the following contact phone number (931) 215-2182.

The enumeration date for this NPI number is 11/16/2012 and was last updated on 7/14/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	1000000011378	TENNESSEE	No
2	104100000X	Social Worker		1000000011378	TENNESSEE	No
3	1041C0700X	Social Worker	Clinical	1000000011378	TENNESSEE	No
4	251S00000X	Community/Behavioral Health		1000000011378	TENNESSEE	No
5	253Z00000X	In Home Supportive Care		1000000011378	TENNESSEE	No
6	101YM0800X	Counselor	Mental Health	LPC00000003314	TENNESSEE	No
7	251V00000X	Voluntary or Charitable		1000000018345	TENNESSEE	No
8	101YM0800X	Counselor	Mental Health	1000000018345	TENNESSEE	No
9	101YP2500X	Counselor	Professional	1000000011378	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1962746842	OTHER	TENNESSEE	GROUP NPI
2	1669548608	OTHER	TENNESSEE	SUPERVISING PROVIDER NPI
3	H445654	MEDICAID	TENNESSEE
4	Q010864	MEDICAID	TENNESSEE
5	NPI 1265768428	OTHER	TENNESSEE	SUPERVISOR
6	1225450802	OTHER	TENNESSEE	INDIVIDUAL PROVIDER NPI
7	Q006613	MEDICAID	TENNESSEE
8	1437420742	MEDICAID	TENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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