LEGACY COUNSELING SERVICES, LLC (NPI# 1174142715) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174142715 |
| Entity Type | Organization |
| Organization Name | LEGACY COUNSELING SERVICES, LLC |
| Practice Address |
4500 Forbes Blvd Ste 200 Lanham MD 20706-6316 |
| Mailing Address |
11203 Champlain Cir Bowie MD 20720-3490 |
| Practice Telephone | 3012656150 |
| Mailing Telephone | 3015386103 |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2020-04-14 |
| Authorized Official Name | AMINA ALEEM HALL (DIRECTOR/PSYCHOTHERAPIST) |
| Authorized Official Telephone | 3012656150 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093326118 | Legacy Counseling Services, LLC | Community/Behavioral Health | 1435 Grand Ave, Yazoo City, MS 39194-2651 | 2020-08-12 |
| 1689103251 | Legacy Counseling Services, LLC | Clinic/Center | 6715 State Park Rd, Travelers Rest, SC 29690-1831 | 2017-06-07 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | LEGACY COUNSELING SERVICES, LLC | 1435 Grand Ave, Yazoo City, MS 39194-2651 |
| Colorado Business Entities | Legacy Counseling Services, LLC | 7669 Coventry Dr., Castle Rock, CO 80108 |
| Oregon Corporations, Companies and Business Names | LEGACY COUNSELING SERVICES, LLC | 880 Liberty St Ne, Salem, OR 97301 |
| Street Address |
4500 FORBES BLVD STE 200 |
| City | LANHAM |
| State | MD |
| Zip Code | 20706-6316 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518033588 | Phyllis Martin-davis | Counselor | 4500 Forbes Blvd Ste 200, Lanham, MD 20706-6316 | 2006-11-28 |
| 1255932166 | Jennifer Ross | Social Worker | 4500 Forbes Blvd Ste 200, Lanham, MD 20706-6316 | 2020-11-06 |
| 1528669959 | Monique Sylvia Fisher | Social Worker | 4500 Forbes Blvd Ste 200, Lanham, MD 20706-6316 | 2020-11-03 |
| 1942835533 | Alpha Bah | Registered Nurse | 4500 Forbes Blvd Ste 200, Lanham, MD 20706-6316 | 2020-03-04 |
| 1700445855 | Pmd Cares LLC | Social Worker | 4500 Forbes Blvd Ste 200, Lanham, MD 20706-6316 | 2019-06-12 |
| 1194282020 | Destined Home Care Services, LLC | Home Health | 4500 Forbes Blvd Ste 200, Lanham, MD 20706-6316 | 2019-02-27 |
| 1922537067 | Eyerosie LLC | Clinic/Center | 4500 Forbes Blvd Ste 200, Lanham, MD 20706-6316 | 2017-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760046775 | Ayesha Tappin | Occupational Therapist | 4200 Parliament Pl. Ste 550, Lanham, MD 20706 | 2019-04-24 |
| 1790240646 | Himabindu Gangavarapu Vinodrao | Nurse Practitioner | 8118, Good Luck Road, Lanhham, MD 20706 | 2019-02-05 |
| 1538644943 | Win Team, LLC | Clinic/Center | 10001 Derekwood Lane, Suite 210, Lanham, MD 20706 | 2018-10-02 |
| 1558846394 | Brieana Moore | Behavioral Analyst | 4551 Parliament Place Suite A, Lanham, MD 20706 | 2018-09-27 |
| 1225511553 | Melvis Afanwi Chi | Home Health Aide | 9861 Goodluck Rd, T1, Lanham, MD 20706 | 2018-09-12 |
| 1346722766 | Elsie Clarke | Nurse Practitioner | 9470 Annapolis Road Suite 311, Lanham, MD 20706 | 2018-09-01 |
| 1821576141 | Amie Da Silva | Nurse Practitioner | 5724 Edge Avenue, Lanham, MD 20706 | 2018-07-30 |
| 1033697313 | Iyadunni Omolara Olukorede | Home Health Aide | 9789 Good Luck Rd Apt 9, Lanham, MD 20706 | 2018-07-30 |
| 1447741459 | A Step Ahead Preventive and Holistic Wellness Center LLC | Psychologist | 4500 Forbes Blvd # 200-w12, Lanham, MD 20706 | 2018-05-24 |
| 1902394398 | Ezekiel Kelechukwu Nwafor | Home Health Aide | 5447 85th Ave Apt 202, Lanham, MD 20706 | 2018-05-01 |
| Find all providers in zip 20706 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811504822 | Susanna Marie Fields-kuehl | Counselor | 9470 Annapolis Rd Ste 308, Lanham, MD 20706-3077 | 2020-09-24 |
| 1497310676 | Breakthroughs Psychological Services, LLC | Counselor | 4421 Forbes Blvd Ste F, Lanham, MD 20706-4384 | 2019-05-03 |
| 1184199614 | Richard Anthony Dulaney | Counselor | 5900 Princess Garden Pkwy Ste 670, Lanham, MD 20706-2957 | 2018-10-11 |
| 1689155350 | Jordan Katherine Lyle | Counselor | 7404 Executive Pl Ste 102, Lanham, MD 20706-6230 | 2018-08-22 |
| 1649675166 | Kilolo Ajanaku | Counselor | 7212 Lost Spring Ct, Lanham, MD 20706-3834 | 2014-10-27 |
| 1467860122 | Amanda Welch | Counselor | 9103 Woodmore Center Dr, 207, Lanham, MD 20706-1653 | 2014-07-25 |
| 1265628812 | Kevin Barwick | Counselor | 6944 Nashville Rd, Lanham, MD 20706-4614 | 2007-09-18 |
| 1023203965 | Ajunwa Nwogu | Counselor | 9332 Annapolis Rd Ste 303a, Lanham, MD 20706-3113 | 2007-09-13 |
| 1457559395 | Progressive Therapeutic Services | Counselor | 4409 Forbes Blvd, Suite B, Lanham, MD 20706-4373 | 2007-07-03 |
| 1134330582 | Tarrah Bonaparte | Counselor | 6406 Cipriano Rd, Lanham, MD 20706-3968 | 2007-05-25 |
| Find all providers in LANHAM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.