LEGACY COUNSELING AND CONSULTING, LLC (NPI# 1114483658) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114483658 |
| Entity Type | Organization |
| Organization Name | LEGACY COUNSELING AND CONSULTING, LLC |
| Practice Address |
3790 Old Us 41 N Ste A Valdosta GA 31602-6865 |
| Mailing Address |
4986 Summit Ridge Rd Valdosta GA 31602 |
| Practice Telephone | 2292621000 |
| Mailing Telephone | 2296305982 |
| Enumeration Date | 2019-02-19 |
| Last Update Date | 2019-06-03 |
| Authorized Official Name | MRS. RACHAEL DUDLEY (OWNER) |
| Authorized Official Telephone | 2296305982 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2109 N Patterson St Ste B, Valdosta, GA 316022577 | 2292324833 |
| Street Address |
3790 OLD US 41 N STE A |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31602-6865 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235100348 | Rachael Dawn Dudley | Social Worker | 3790 Old Us 41 N Ste A, Valdosta, GA 31602-6865 | 2006-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477198117 | Amber Michele Baugh | Behavior Technician | 2236 Bemiss Road, Valdosta, GA 31602 | 2019-11-15 |
| 1528611365 | Nishaben T. Patel | Nurse Practitioner | 3120 North Oak Street Extension, Suite B, Valdosta, GA 31602 | 2019-07-22 |
| 1427615871 | Blair Elizabeth Tomlinson | Nurse Practitioner | 2124 Lakeshore Drive, Valdosta, GA 31602 | 2019-05-21 |
| 1346704152 | Mildred Itaska Borowski | Counselor | 3790 North Highway 41, Suite A, Valdosta, GA 31602 | 2019-01-25 |
| 1962991703 | Southern Healthcare Alliance, LLC | Physical Medicine & Rehabilitation | 101-f W. Northside Drive, Valdosta, GA 31602 | 2018-05-08 |
| 1336636646 | Kaitlyn Thrift | Behavioral Analyst | 2225 Bemiss Road Suite D, Valdosta, GA 31602 | 2018-04-23 |
| 1407379845 | Lindsey Marie Richardson | Dentist | 103 W. Cranford Ave, Valdosta, GA 31602 | 2017-07-18 |
| 1962922427 | Taylor Nicole Fiveash | Nurse Practitioner | 101 W Northisde Dr, Bldg G, Valdosta, GA 31602 | 2017-06-26 |
| 1720520646 | Southern Sleepers Anesthesia LLC | Nurse Anesthetist, Certified Registered | 4120-b N. Valdosta Road, Valdosta, GA 31602 | 2016-11-09 |
| 1134670557 | Cataract and Laser Surgery Center of South Georgia, P.C. | Clinic/Center | 4120-b N. Valdosta Rd., Valdosta, GA 31602 | 2016-10-20 |
| Find all providers in zip 31602 | ||||
| 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 |
|---|---|---|---|---|
| 1942654512 | Mcdougle Personal Care Home Inc | Community/Behavioral Health | 808 Bethune St, Valdosta, GA 31601-6202 | 2016-04-20 |
| 1508290099 | Pinnacle Counseling Services | Community/Behavioral Health | 1205 Baytree Road #8, Valdosta, GA 31602 | 2013-09-03 |
| 1548693039 | L.e.a.f. Therapy Services, LLC | Community/Behavioral Health | 223 N Ashley St, Ste 311, Valdosta, GA 31601-5694 | 2013-08-20 |
| 1093078958 | Life Counseling and Dui School Services | Community/Behavioral Health | 3720 Bermuda Run Dr, Valdosta, GA 31605-1060 | 2012-06-15 |
| 1811253719 | Pinnacle Counseling Services, LLC | Community/Behavioral Health | 1205 Baytree Rd Ste 8, Valdosta, GA 31602-2782 | 2012-04-04 |
| 1447488929 | Gregory E. Pye, Ph.d, PC | Community/Behavioral Health | 1810 Plum St, Suite F, Valdosta, GA 31601-7529 | 2009-06-23 |
| 1578703385 | Pathway To Hope Counseling Services, Inc. | Community/Behavioral Health | 1341 W Hill Ave, Valdosta, GA 31601-5235 | 2009-03-06 |
| 1104027374 | Employment Matters, Inc | Community/Behavioral Health | 704 Pineview Dr, Valdosta, GA 31602-1925 | 2007-05-29 |
| 1841328960 | Choices for Life of Georgia, LLC | Community/Behavioral Health | 2200 N Patterson Street, Suite D, Valdosta, GA 31602-2573 | 2007-03-01 |
| 1316350457 | Springhealth Behavioral Health and Integrated Care Georgia, LLC | Community/Behavioral Health | 1705 River St, Valdosta, GA 31601 | 2014-06-06 |
| Find all providers in VALDOSTA | ||||
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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.