Provider Demographics
NPI:1427919653
Name:LEGACY COUNSELING & CONSULTING LLC
Entity type:Organization
Organization Name:LEGACY COUNSELING & CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:TE-NAIL
Authorized Official - Middle Name:MONEE'
Authorized Official - Last Name:GAYDEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:808-494-4606
Mailing Address - Street 1:PO BOX 94
Mailing Address - Street 2:
Mailing Address - City:FLORA
Mailing Address - State:MS
Mailing Address - Zip Code:39071-0094
Mailing Address - Country:US
Mailing Address - Phone:808-494-4606
Mailing Address - Fax:
Practice Address - Street 1:10 CANEBRAKE BLVD STE 110-118
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-2211
Practice Address - Country:US
Practice Address - Phone:808-494-4606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-18
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty