Livingwell Collaborative, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

LIVINGWELL COLLABORATIVE, LLC

Practice address

2751 Buford Hwy NE Ste 410
Atlanta, GA 30324-5457

Phone

(404) 689-7100

NPI assigned

Mar 3, 2020

Organization subpart

No

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

Authorized official

Name

Patricia Scruggs, LPCNPI 1639617277

Title

Owner

Phone

(404) 689-7100

Specialties & licenses 2

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Patricia Scruggs, LAPC

  • Mental Health Counselor
  • Atlanta, GA
  • NPI 1639617277
  NPD (past) Authorized official

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

{
    "created_epoch": "1583193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587081600000",
    "number": "1114552874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6875 PEACHTREE DUNWOODY RD APT 312",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285727",
            "telephone_number": "404-787-6146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 BUFORD HWY NE STE 410",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303245457",
            "telephone_number": "404-689-7100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 W Ponce De Leon Ave Ste 725",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300302464",
            "country_code": "US",
            "telephone_number": "404-689-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIVINGWELL COLLABORATIVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-03",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A",
        "authorized_official_last_name": "SCRUGGS",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-689-7100",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.livingwell.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2751 Buford Hwy NE Ste 410",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303245457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Living Well Integrative Counseling, LLC
• Living Well Primary Care/Urgent Care Clinic
• Kelly Leigh Livingston
• Sallie Livingston, LCSW
• Tawian McKennon Livingston, MD
• Jessica Hope Livsey, MD
• Kimberly Taylor Livsey, LPC
• Livvey HC LLC
• Jose Fernando Lizcano-Perez, M.D.
• LK Psych Health

• Professional Counselor in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2020; 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.