| Legacy Behavioral Health Solutions, Llc | |
|
850 Mill St Ste 200 Reno NV 89502-1435 | |
| (702) 942-1774 | |
| (702) 942-1773 |
| Full Name | Legacy Behavioral Health Solutions, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 850 Mill St Ste 200, Reno, Nevada |
| Authorized Official Name and Position | Abby Grossa (CFO) |
| Authorized Official Contact | 7023388373 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Behavioral Health Solutions, Llc 2921 N Tenaya Way Las Vegas NV 89128-1409 Ph: (702) 942-1774 | Legacy Behavioral Health Solutions, Llc 850 Mill St Ste 200 Reno NV 89502-1435 Ph: (702) 942-1774 |
| NPI Number | 1548614514 |
|---|---|
| Provider Enumeration Date | 04/15/2016 |
| Last Update Date | 03/05/2023 |
| Certification Date | 03/05/2023 |
| Medicare PECOS PAC ID | 5890161947 |
|---|---|
| Medicare Enrollment ID | O20221014002253 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548614514 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | David J Ventrelle |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639342140 PECOS PAC ID: 1850437369 Enrollment ID: I20220815000650 |
| Provider Name | Liam Alexander Paige |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083969885 PECOS PAC ID: 1052795846 Enrollment ID: I20220828000082 |
| Provider Name | Michaela Koenig |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346581295 PECOS PAC ID: 5991173056 Enrollment ID: I20221121001388 |
| Provider Name | Alicia Scott |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518197185 PECOS PAC ID: 6406208719 Enrollment ID: I20240122003912 |
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