Organization Active NPI

Dr. Livengood Psychology, PSYD, PLLC

  • Clinical Psychologist
  • Panama City, FL
National Provider Identifier
1396464756
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
DR. LIVENGOOD PSYCHOLOGY, PSYD, PLLC
Practice address
1315 W 17TH St Unit 15034
Panama City, FL 32406-7702
Phone
(850) 276-6401
Fax
(850) 792-6916
NPI assigned
Aug 26, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Authorized official

Name
Dr. Tara Livengood, PSYDNPI 1649750753
Title
Psychologist/Owner
Phone
(850) 276-6401

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

1315 W 17TH St Unit 15034
Panama City, FL 32406-7702

Mailing address

1315 W 17TH St Unit 15034
Panama City, FL 32406-7702
Phone (850) 276-6401

Other practice location 1

1005 Marlandwood Rd Ste 114
Temple, TX 76502-3331
Phone (254) 228-0404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220916002367 TX Part B Supplier - Clinic/Group Practice 6507241148 Receives reassigned benefits from 1 practitioner
Practice locations: Temple, TX
O20250307000235 FL Part B Supplier - Clinic/Group Practice 6507241148 Receives reassigned benefits from 1 practitioner
Practice locations: Panama City Beach, FL

National Provider Directory

National Provider Directory

Locations

1315 W 17th St
Unit 15034
Panama City, FL 32406
Phone (850) 276-6401

1005 Marlandwood Rd
Ste 114
Temple, TX 76502
Phone (254) 228-0404

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1661472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739318400000",
    "number": "1396464756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 W 17TH ST UNIT 15034",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324067702",
            "telephone_number": "850-276-6401",
            "fax_number": "850-792-6916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 W 17TH ST UNIT 15034",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324067702",
            "telephone_number": "850-276-6401",
            "fax_number": "850-792-6916"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1005 Marlandwood Rd Ste 114",
            "address_purpose": "LOCATION",
            "city": "Temple",
            "state": "TX",
            "postal_code": "765023331",
            "country_code": "US",
            "telephone_number": "254-228-0404",
            "fax_number": "254-228-0505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DR. LIVENGOOD PSYCHOLOGY, PSYD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-26",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A",
        "authorized_official_last_name": "LIVENGOOD",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "850-276-6401",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.