LEGACY LIFE COUNSELING & CONSULTING INC (NPI# 1255930533) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255930533 |
| Entity Type | Organization |
| Organization Name | LEGACY LIFE COUNSELING & CONSULTING INC |
| Practice Address |
420 N El Camino Real Oceanside CA 92058-7868 |
| Mailing Address |
825 College Blvd Ste 102-336 Oceanside CA 92057-6263 |
| Practice Telephone | 7602124311 |
| Mailing Telephone | 7602124311 |
| Enumeration Date | 2020-10-19 |
| Last Update Date | 2020-10-19 |
| Authorized Official Name | MRS. SHANNON DEON MORELL (CEO) |
| Authorized Official Telephone | 7602124311 |
| Authorized Official Credential | LMFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Street Address |
420 N EL CAMINO REAL |
| City | OCEANSIDE |
| State | CA |
| Zip Code | 92058-7868 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609176007 | Shannon Deon Morell | Marriage & Family Therapist | 420 N El Camino Real, Oceanside, CA 92058-7868 | 2010-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508463555 | Michael William Baker | Dental Hygienist | 14th St., Oceanside, CA 92058 | 2020-10-02 |
| 1548877004 | Juliaisa Gisselle Caldero | Dental Assistant | Bldg 13128, Oceanside, CA 92058 | 2020-09-29 |
| 1932715836 | Leilani Viveros | Behavior Technician | 251 Airprort Road, Oceanside, CA 92058 | 2020-09-17 |
| 1043835952 | Emma Caitlin Johnson | Dentist | 92055 14th St, Bldg 13128, Oceanside, CA 92058 | 2020-06-16 |
| 1073135836 | Roxana Ivette Rodriguez | Military Health Care Provider | 22190 Marine Dr, Oceanside, CA 92058 | 2020-05-14 |
| 1699307744 | Rachael Bousman | Specialist/Technologist | 13129 14th St, Area 13, Camp Pendleton, CA 92058 | 2020-02-06 |
| 1811528359 | Misaael Valdes | Military Health Care Provider | Building, B St, Oceanside, CA 92058 | 2020-02-03 |
| 1497385736 | Phong Thanh Tran | Dental Hygienist | 599 A Ave #501, Oceanside, CA 92058 | 2020-01-24 |
| 1245796366 | Christian Thompson | Physician Assistant | 1st Med Bn, Camp Pendleton, Oceanside, CA 92058 | 2019-02-13 |
| 1104308568 | Caila Martin | Behavior Technician | 293 Douglas Dr Apt. 272, Oceanside, CA 92058 | 2018-09-02 |
| Find all providers in zip 92058 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497369987 | Crownview Telehealth Instiute LLC | Community/Behavioral Health | 315 North Clementine Street, Oceanside, CA 92054 | 2020-09-02 |
| 1154972966 | Naomi C Martin, Marriage and Family Counseling Inc. | Community/Behavioral Health | 2111 S El Camino Real # 30092054, Oceanside, CA 92054-9001 | 2019-09-23 |
| 1639640212 | Crownview Co-occurring Institute | Community/Behavioral Health | 212 N Clementine St, Oceanside, CA 92054-2805 | 2018-12-07 |
| 1386130961 | Renew Behavioral Health | Community/Behavioral Health | 1431 Enchante Way, Oceanside, CA 92056-5675 | 2018-07-06 |
| 1114422540 | Jennifer Reyes | Community/Behavioral Health | 244 Hemlock Way, Oceanside, CA 92057-6646 | 2018-03-27 |
| 1093165243 | Del Mar Support Services, LLC | Community/Behavioral Health | 1523 San Mateo St, Oceanside, CA 92058-1126 | 2016-06-20 |
| 1346611233 | Michelle Conti Psyd LLC | Community/Behavioral Health | 2889 Davis St, Oceanside, NY 11572-2014 | 2015-10-18 |
| 1992034748 | Beth Vardaro Lcsw PC | Community/Behavioral Health | 341 Links Dr E, Oceanside, NY 11572-5624 | 2009-12-08 |
| 1013146224 | Denis Eduardo Blumberg Lcsw-r | Community/Behavioral Health | 285 Merrifield Ave, Oceanside, NY 11572-2913 | 2009-07-09 |
| 1023213592 | North County Lifeline | Community/Behavioral Health | 707 Oceanside Blvd, Oceanside, CA 92054-5225 | 2007-06-15 |
| Find all providers in OCEANSIDE | ||||
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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.