Legacy League Family Wellness LLC
NPI 1487361234ActiveOrganization· Social Worker, Clinical· Jamaica, NY
Social Worker, Clinical in Jamaica, New York, registered in NPPES in November 2022. The authorized official on file is Twila Evanson, LCSW, Executive Director. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1487361234 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 1, 2022 |
| Last updated in NPPES | Nov 1, 2022 |
| Certified by provider | Nov 1, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NY) |
|---|
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