| My Legacy Counseling Services, Llc | |
|
1510 Willow Lawn Dr Richmond VA 23230-3429 | |
| (804) 214-2354 | |
| Not Available |
| Full Name | My Legacy Counseling Services, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1510 Willow Lawn Dr, Richmond, Virginia |
| Authorized Official Name and Position | Lakesha Broussard (DIRECTOR) |
| Authorized Official Contact | 8049013458 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| My Legacy Counseling Services, Llc 7305 Hancock Village Dr Ste 315 Chesterfield VA 23832-2771 Ph: (804) 901-3458 | My Legacy Counseling Services, Llc 1510 Willow Lawn Dr Richmond VA 23230-3429 Ph: (804) 214-2354 |
| NPI Number | 1366907834 |
|---|---|
| Provider Enumeration Date | 02/08/2019 |
| Last Update Date | 02/08/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366907834 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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