MR. LARRY JACKSON LEGG (NPI# 1366571499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366571499 |
| Entity Type | Individual |
| Full Name | MR. LARRY JACKSON LEGG |
| Credential | M.A. |
| Practice Address |
702 Professional Park Dr Ste 106 Summersville WV 26651-2033 |
| Mailing Address |
3883 Farmdale Rd Meadow Bridge WV 25976-7035 |
| Practice Telephone | 3048832380 |
| Practice Fax Number | 3048832383 |
| Mailing Telephone | 3046612742 |
| Mailing Fax Number | 3043926835 |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2017-01-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
630 | WV | Behavioral Health & Social Service Providers |
| N | 103TC1900X |
Psychologist Specialization: Counseling |
630 | WV | Behavioral Health & Social Service Providers |
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
630 | WV | Behavioral Health & Social Service Providers |
| N | 103TM1800X |
Psychologist Specialization: Mental Retardation & Developmental Disabilities |
630 | WV | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609981430 | Larry Theodore Legg II | Social Worker | 8019 N Himes Ave, Suite 311, Tampa, FL 33614-2712 | 2006-08-20 |
| Street Address |
702 PROFESSIONAL PARK DR STE 106 |
| City | SUMMERSVILLE |
| State | WV |
| Zip Code | 26651-2033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780647784 | John K Lackey | Ophthalmology | 702 Professional Park Dr, Suite 102, Summersville, WV 26651-2018 | 2006-04-10 |
| 1619410693 | Summersville Outpatient Center | Urology | 702 Professional Park Dr, Summersville, WV 26651-2018 | 2016-11-23 |
| 1205951605 | Dr John Lackey Inc | Ophthalmology | 702 Professional Park Dr, Suite 102, Summersville, WV 26651-2018 | 2007-03-21 |
| 1609904663 | John Lackey, Inc | Eyewear Supplier (Equipment, not the service) | 702 Professional Park Dr, Suite102, Summersville, WV 26651-2018 | 2007-03-01 |
| 1023122041 | Robert Charles Stanley | Family Medicine | 702 Professional Park Dr, Suite 100, Summersville, WV 26651-2018 | 2006-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568061588 | Marcy Nicole Myerholtz | Pharmacist | 700 Northside Drive, Cvs Pharmacy, Summersville, WV 26651 | 2020-10-21 |
| 1104425396 | Travis Giles | Physical Therapy Assistant | 2129 Canvas Nettie Rd, Summersville, WV 26651 | 2020-10-20 |
| 1043837586 | Clorinda L Workman | Registered Nurse | 221 Bright of America Road, Summersville, WV 26651 | 2020-07-01 |
| 1669947222 | Camden On Gauley Medical Center, Inc. | Clinic/Center | 70 Grade School Lane, Summersville, WV 26651 | 2018-10-10 |
| 1902310451 | Carolyn Maxwell Evans | Technician | 554 Ritchie Farm Road, Summersville, WV 26651 | 2017-11-20 |
| 1568904829 | Nicholas Community Action Partnership, Inc | Case Management | 1205 Broad Street, Summersville, WV 26651 | 2016-11-17 |
| 1831645647 | Rachel Hendricks | Psychologist | 400 Old Main Drive, Nicholas County Schools, Summersville, WV 26651 | 2016-08-31 |
| 1831592542 | Vass Vocational Services, In. | Case Manager/Care Coordinator | 304 Bibb Lane, Summersville, WV 26651 | 2014-10-08 |
| 1417229329 | Professional Medical Ultrasonics Inc. | Clinic/Center | 4089 Webster Rd Suite 5, Summersville, WV 26651 | 2012-02-08 |
| 1437426459 | All Med, LLC | Durable Medical Equipment & Medical Supplies | 602 Appalachian Dr., Summersville, WV 26651 | 2011-11-18 |
| Find all providers in zip 26651 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134200769 | Chameleon Health Care Inc | Psychologist | 846 Northside Drive, Suite 15, Summersville, WV 26651-2028 | 2006-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760083927 | Kimberly Adele Hughes | Psychologist | 310 Cambridge Pointe, Charleston, WV 25309-8596 | 2020-11-04 |
| 1750915286 | Britani Shaye Black | Psychologist | 1115 20th St Ste 200, Huntington, WV 25703-2071 | 2020-02-24 |
| 1316579493 | Continuous Journey | Psychologist | 179 E Burr Blvd Ste F, Kearneysville, WV 25430-4964 | 2020-02-06 |
| 1912537424 | Miyuki N. Ege | Psychologist | 333 Laidley St Fl 4e, Charleston, WV 25301-1614 | 2020-01-23 |
| 1811537715 | Brandon C Dean | Psychologist | 4857 Macorkle Ave. Sw, South Charleston, WV 25309 | 2020-01-09 |
| 1619466463 | Mh Psychological Services, Pllc | Psychologist | 125 Morris Ct, Hurricane, WV 25526 | 2018-05-08 |
| 1104322320 | Kara Caldwell | Psychologist | 333 Laidley St., 4'th Floor East, Charleston, WV 25301 | 2018-04-05 |
| 1972009405 | Rachel Sherman | Psychologist | 82 Pine St., Franklin, WV 26807-0100 | 2018-04-03 |
| 1518474311 | Brian C Hanasky | Psychologist | 87 15th St, Wheeling, WV 26003-3548 | 2018-01-03 |
| 1952854267 | Kathryn Hemker, Ph.d. Pllc | Psychologist | 145 N Hills Dr, Parkersburg, WV 26104-9216 | 2016-08-03 |
| Find all providers with the same taxonomy | ||||
| City | SUMMERSVILLE |
| Zip Code | 26651 |
Please comment or provide details below to improve the information on MR. LARRY JACKSON LEGG.
| 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.