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

Last updated

Dec 22, 2008By the provider in NPPES

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Professional Clinical Management

  dba Preferred Family Clinic

  • 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.