Individual provider Active NPI

Lisa Yetta Livshin, ED.D

  • Counseling Psychologist
  • Newton, MA
National Provider Identifier
1417946757
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
4819 Issued in MA
Practice address
69 Margaret Rd
Newton, MA 02461-1610
Phone
(617) 244-2070
Fax
(617) 244-2070
NPI assigned
Oct 19, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 4819 MA Primary

Addresses

Primary practice location

69 Margaret Rd
Newton, MA 02461-1610

Mailing address

69 Margaret Rd
Newton, MA 02461-1610
Phone (617) 244-2070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070116000374 MA Practitioner - Clinical Psychologist 4880695907 Practice locations: Brookline, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

47 Corey Rd
Brookline, MA 02445-2147
Phone (617) 276-5010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417946757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 MARGARET RD",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024611610",
            "telephone_number": "617-244-2070",
            "fax_number": "617-244-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 MARGARET RD",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024611610",
            "telephone_number": "617-244-2070",
            "fax_number": "617-244-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVSHIN",
        "first_name": "LISA",
        "middle_name": "YETTA",
        "name_prefix": "Dr.",
        "credential": "ED.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MA",
            "license": "4819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

Verify at the official NPI Registry.