Nicholas Jay Livingston
Individual provider Active NPI Counselor · Cache, OK
NPI 1326392267 · NPPES record last updated Jul 20, 2015
Key facts
- NPI
- 1326392267
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 15939 SW Lee Blvd
Cache, OK 73527-3027 - Phone
- (580) 699-0295
- NPI assigned
- Oct 30, 2012
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
15939 SW Lee Blvd
Cache, OK 73527-3027
Mailing address
15939 SW Lee Blvd
Cache, OK 73527-3027
Other providers in Cache, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.