Organization
LEGACY CLINICAL CONSULTANTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY BRIAN VANMETER PSYD (EXECUTIVE DIRECTOR)
(877) 443-7030
Entity
Organization
Contact information
Practice address
3033 OGDEN AVE STE 200, LISLE, IL 60532-1976
(877) 443-7030
Mailing address
13300 S ROUTE 59, SUITE B-7, PLAINFIELD, IL 60585-9847
(815) 577-3666
(815) 577-2785
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103G00000X
Clinical Neuropsychologist
Primary
—
—
103T00000X
Psychologist
—
—
103TA0700X
Adult Development & Aging Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
071.006312
IL
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TF0000X
Family Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
149.008075
IL
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9932120
BLUE CROSS BLUE SHIELD
IL
Enumeration date
02/16/2006
Last updated
04/05/2024
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