Larry Livermore

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1-04619 Issued in MI

Practice address

3865 S Mackinac TRL
Sault Sainte Marie, MI 49783-9286

Phone

(906) 632-2805

Fax

(906) 632-1163

NPI assigned

Nov 15, 2010

Last updated

Nov 15, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1289779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289779200000",
    "number": "1013218585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 N LAKE ST",
            "city": "MANISTIQUE",
            "state": "MI",
            "postal_code": "498541234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3865 S MACKINAC TRL",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497839286",
            "telephone_number": "906-632-2805",
            "fax_number": "906-632-1163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVERMORE",
        "first_name": "LARRY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-15",
        "last_updated": "2010-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "1-04619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa M Lewicki, MA., CCC-SLP
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• Lincare Inc.
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• Shannon Love, RPH
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• Jeffrey William Lozen, O.D.
• Jovan Lozo

• Addiction (Substance Use Disorder) Counselor in Sault Sainte Marie, MI
• Providers in Sault Sainte Marie, MI by specialty
• Addiction (Substance Use Disorder) Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.