| The Leggett Group Llc | |
|
4238 Washington St Ste 316 Roslindale MA 02131-2517 | |
| (617) 851-0171 | |
| Not Available |
| Full Name | The Leggett Group Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4238 Washington St Ste 316, Roslindale, Massachusetts |
| Authorized Official Name and Position | Jennifer Alyssa Erbe Leggett (OWNER AND DIRECTOR) |
| Authorized Official Contact | 6178510171 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Leggett Group Llc 4238 Washington St Ste 316 Roslindale MA 02131-2517 Ph: (617) 851-0171 | The Leggett Group Llc 4238 Washington St Ste 316 Roslindale MA 02131-2517 Ph: (617) 851-0171 |
| NPI Number | 1013342773 |
|---|---|
| Provider Enumeration Date | 09/12/2013 |
| Last Update Date | 09/12/2013 |
| Medicare PECOS PAC ID | 2860798832 |
|---|---|
| Medicare Enrollment ID | O20160317000764 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013342773 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 111254 (Massachusetts) | Primary |
| Provider Name | Jennifer Alyssa Erbe Leggett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689618134 PECOS PAC ID: 1254334261 Enrollment ID: I20060811000444 |
| Provider Name | Constance K Wynne |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043486095 PECOS PAC ID: 6709949761 Enrollment ID: I20090116000491 |
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