Legg, Larry Jackson

Legg, Larry Jackson is an individual health care provider with primary practice located at 702 Professional Park Dr Ste 106, Summersville WV 26651-2033. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Counseling, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Legg, Larry Jackson can be contacted via phone (304) 883-2380.

Contact Information

Primary practice address
702 Professional Park Dr Ste 106 Summersville WV 26651-2033
Phone: (304) 883-2380
Fax: (304) 883-2383
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 630 West Virginia
Behavioral Health & Social Service Providers / Counseling 103TC1900X 630 West Virginia
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 630 West Virginia
Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities 103TM1800X 630 West Virginia

Profile Details

NPI number 1366571499
LBN Legal business name Legg, Larry Jackson
Credentials Master of Arts (MA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 5th, 2007
Last updated Jan 27th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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