Provider Demographics
NPI:1730785353
Name:LEGENDRE, AMII (LMSW)
Entity type:Individual
Prefix:
First Name:AMII
Middle Name:
Last Name:LEGENDRE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 ANNANDALE RD
Mailing Address - Street 2:
Mailing Address - City:RED HOOK
Mailing Address - State:NY
Mailing Address - Zip Code:12571-3608
Mailing Address - Country:US
Mailing Address - Phone:206-351-0777
Mailing Address - Fax:
Practice Address - Street 1:325 COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-1902
Practice Address - Country:US
Practice Address - Phone:518-828-9446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health