John Dale Livingstone, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

4923696-2501 Issued in UT

Practice address

1355 N University Ave
Suite 200
Provo, UT 84604-2721

Phone

(801) 221-0223

Fax

(801) 221-0291

NPI assigned

Dec 22, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: john.livingston.p1@direct.alpinepeds.nextgenshare.com

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

• Professional Clinical Management

  • Psychologist
  • Provo, UT
  • NPI 1023263191
  NPD (past)

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

{
    "created_epoch": "1229904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229904000000",
    "number": "1710123765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 N UNIVERSITY AVE",
            "address_2": "SUITE 200",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846042721",
            "telephone_number": "801-221-0223",
            "fax_number": "801-221-0291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 N UNIVERSITY AVE",
            "address_2": "SUITE 200",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846042721",
            "telephone_number": "801-221-0223",
            "fax_number": "801-221-0291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVINGSTONE",
        "first_name": "JOHN",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-22",
        "last_updated": "2008-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "UT",
            "license": "4923696-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy Anne Liu, MS
• Sierra Cherie Livermore
• Darin R Livingston, PT
• Emily Livingston
• Melanie S Livingston, RN, BSN
• Emily Llewellyn
• Jeremy Llewellyn, APRN
• Abigail Kathleen Lloyd
• Angeline Lloyd, MA, LMFT
• Charles Christopher Lloyd

• Clinical Child & Adolescent Psychologist in Provo, UT
• Providers in Provo, UT by specialty
• Clinical Child & Adolescent Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.