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LEGACY 4 CHANGE
NPI 1912664509
Social Worker - Clinical in Jackson, MS

Active since November 18, 2021
2891 TERRY RD, JACKSON, MS 39212(769) 203-8141 Get Directions Write a Review

NPPES record last updated: January 20, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 20, 2022, Nov 29, 2021, Nov 18, 2021 (3 updates tracked since 2021).

About Legacy 4 Change NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LEGACY 4 CHANGE (NPI 1912664509) is a healthcare organization registered as a clinical in Jackson, Mississippi and active in the NPI registry since November 2021. The organization lists Chasity Davis, President, as its authorized official.

NPPES Registry Identity

NPI1912664509
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameLEGACY 4 CHANGE
Location Address2891 TERRY RDJackson, MS 39212-3051
Mailing AddressPo Box 821878Vicksburg, MS 39182-1878 · (769) 203-8141
Phone(769) 203-8141
Organization SubpartNo
Authorized OfficialChasity DavisPresident · (769) 203-8141
Enumeration DateNovember 18, 2021
Last NPPES UpdateJanuary 20, 20223 updates tracked since enumeration
NPPES CertifiedJanuary 20, 2022
✔ NPI 1912664509 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
2891 TERRY RD, Jackson, MS 39212
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LEIGH TANYA WALKER DMD
Dentist
2891 TERRY RD
JACKSON, MS 39212
Hinds County (601) 371-1157

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Legacy 4 Change's NPI number?

The NPI number for Legacy 4 Change is 1912664509. It was assigned to this organization in the NPPES registry on November 18, 2021.

Where is Legacy 4 Change located?

Legacy 4 Change is located at 2891 Terry Rd, Jackson, MS 39212. The listed phone number is (769) 203-8141.

What is Legacy 4 Change's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Legacy 4 Change was last updated on January 20, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.