My Legacy Counseling Center, LLC
NPI 1073491221ActiveOrganization· Social Worker, Clinical· Memphis, TN
Social Worker, Clinical in Memphis, Tennessee, registered in NPPES in August 2025. The authorized official on file is Kelli Holloway, LCSW, Owner/Provider. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1073491221 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 25, 2025 |
| Last updated in NPPES | Aug 4, 2026 |
| Certified by provider | Aug 4, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | — | — |
| Clinic/Center, Adult Mental Health | 261QM0850X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (TN) |
|---|
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