Provider Information for 1689035123
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
BETHANY LYNNE LIVINGSTON LMHC
Sex: Female
NPI: 1689035123
Last Updated: 2019-08-28
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1689035123 | ||||||||
| Enumeration Date | 2016-03-11 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 915 BREAKAWAY TRL TITUSVILLE, FL 32780-3263 United States Phone: 321-210-5562 | Fax: | ||||||||
| Primary Practice Address | 5095 S WASHINGTON AVE STE 102 TITUSVILLE, FL 32780-7333 United States Phone: 321-252-8485 | Fax: | ||||||||
| Secondary Practice Address(es) | 142 W LAKEVIEW AVE 915 BREAKAWAY TRL | ||||||||
| Health Information Exchange |
| ||||||||
| Other Identifiers |
| ||||||||
| Taxonomy |
|