Organization · Type 2 NPI
Legacy Behavioral Health Services LLC
Psychiatric/Mental Health Nurse Practitioner · Waldorf, MD
NPI number
1376474783
Active
Practice location
10463 Ponderosa Pine Ave
Waldorf, MD 20603-5794
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | None listed |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1376474783
Legacy Behavioral Health Services LLC's National Provider Identifier is 1376474783, issued on May 26, 2026. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Waldorf, MD. The record was last updated on May 26, 2026.