Living Well, PA

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

04-16P Issued in AR

Legal business name

LIVING WELL, PA

Practice address

1225 Breckenridge Dr
Suite 204
Little Rock, AR 72205-1558

Phone

(501) 255-1574

Fax

(501) 255-1446

NPI assigned

Sep 23, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Jody Lynn Hagen, PHD

Title

President

Phone

(501) 255-1574

Specialties & licenses 3

Addresses

Other names 1

• LIVING WELL, PLLC Former legal business name

Locations

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

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222128000000",
    "number": "1316197759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 206",
            "city": "MABELVALE",
            "state": "AR",
            "postal_code": "721030206",
            "telephone_number": "501-255-1574",
            "fax_number": "501-255-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 BRECKENRIDGE DR",
            "address_2": "SUITE 204",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722051558",
            "telephone_number": "501-255-1574",
            "fax_number": "501-255-1446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WELL, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-23",
        "last_updated": "2008-09-23",
        "status": "A",
        "authorized_official_last_name": "HAGEN",
        "authorized_official_first_name": "JODY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-255-1574",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "AR",
            "license": "04-16P",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "AR",
            "license": "04-16P",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "AR",
            "license": "04-16P",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LIVING WELL, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Hazel K Liverett, MD
• Nathan D. Livers, MD
• Living Hope Institute
• Living Hope Medical Services LLC
• Living Oasis, LLC
• Erika Beshears Livingston, PHARM.D.
• Franklin Livingston, MHPP
• Jennifer Lynn Livingston, APRN
• Laura Jean Livingston, NP
• Richard Connor Livingston, MHPP

• Clinical Neuropsychologist in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Clinical Neuropsychologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; 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.