Individual provider Active NPI

Stephanie L Livingston, PH.D.

  • Psychologist
  • Chicago, IL
National Provider Identifier
1679619332
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
333 N Michigan Ave
Ste. 1801
Chicago, IL 60601-3901
Phone
(773) 509-5117
NPI assigned
Jan 29, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 20041831A IN
Psychologist 103T00000X IL Primary

Addresses

Primary practice location

333 N Michigan Ave
Ste. 1801
Chicago, IL 60601-3901

Mailing address

4554 S Oakenwald Ave
Chicago, IL 60653-4514
Phone (773) 509-5117

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20031107000145 IL Practitioner - Clinical Psychologist 2668385774 Reassigns benefits to 1 organization
I20080620000001 IN Practitioner - Clinical Psychologist 2668385774 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Loyola University of Chicago, Stritch School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

613 Franklin St
Michigan City, IN 46360-3411
Phone (877) 548-7792

8633 W 400
Michigan City, IN 46360-9559

8633 W 400
Michigan City, IN 46360-9854

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071004339ILMDPsychologist
20041831AINMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Biopsychtech of Chicago, LTD Psychologist CurrentSince May 1, 1991 Accepting new patients

Locations

333 N Michigan Ave
Ste 1801
Chicago, IL 60601
Phone (312) 345-0933

333 N Michigan Ave
Ste 1828
Chicago, IL 60601
Phone (312) 332-9947

613 Franklin St
Fl 2
Michigan City, IN 46360

613 Franklin St
Michigan City, IN 46360
Phone (312) 907-3644

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679619332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4554 S OAKENWALD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606534514",
            "telephone_number": "773-509-5117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N MICHIGAN AVE",
            "address_2": "STE. 1801",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606013901",
            "telephone_number": "773-509-5117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVINGSTON",
        "first_name": "STEPHANIE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20041831A",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.