Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Legacy League Family Wellness LLC

Organization Clinical Social Worker · NPI 1487361234

Legacy League Family Wellness LLC is a Clinical Social Worker in Jamaica, New York. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

14215 110th Ave
Jamaica, NY 11435-5624
Phone: (917) 923-5341
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X

Record details

NPI number1487361234
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Twila Evanson — Executive Director · (917) 923-5341
NPI enumeratedNovember 1, 2022
Last updated in NPPESNovember 1, 2022
Certification dateNovember 1, 2022
Mailing address14215 110th Ave, Jamaica, NY 11435-5624

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