OrganizationActive
Legacy 4 Change
NPI 1912664509 · Clinical Social Worker · Jackson, MS
Legacy 4 Change is a Clinical Social Worker organization in Jackson, MS (NPI 1912664509).
Provider details
- NPI number
- 1912664509
- Entity type
- Organization
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Chasity Davis, President(769) 203-8141
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(61/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2891 Terry Rd
Jackson, MS 39212-3051
Phone: (769) 203-8141
Street-level locationGet directions
Mailing address
Po Box 821878
Vicksburg, MS 39182-1878
Registry dates
- Enumerated
- 2021-11-18
- Last updated
- 2022-01-20
- Certified
- 2022-01-20
Frequently asked questions
- What is Legacy 4 Change's NPI number?
- Legacy 4 Change's National Provider Identifier (NPI) is 1912664509, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Legacy 4 Change?
- Legacy 4 Change is classified in the NPPES registry as Clinical Social Worker (Behavioral Health & Social Service Providers).
- Where is Legacy 4 Change located?
- Legacy 4 Change's practice location on file with NPPES is 2891 Terry Rd, Jackson, MS 39212-3051.
- What is Legacy 4 Change's phone number?
- The practice phone number listed in the NPPES registry for Legacy 4 Change is (769) 203-8141.
- Who is the authorized official for Legacy 4 Change?
- The authorized official listed on Legacy 4 Change's NPPES record is Chasity Davis, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Legacy 4 Change's NPI active?
- Yes — Legacy 4 Change's NPI (1912664509) is active in the NPPES registry as of the last update on 2022-01-20.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.