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NPI Code Detail

MEDICARE: MS. MIKEAL ALEXUS LIVAS

MEDICARE: MS. MIKEAL ALEXUS LIVAS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy Assistant350566LA

General Provider Information

NPI Number : 1386597961
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MIKEAL ALEXUS LIVAS
Provider Business Mailing Address
First Line : 178 MORRIS SMITH LN
Second Line :
City : CENTREVILLE
State : MS
Zip : 39631-4141
Country : US
Telephone Number : 504-621-2122
Fax Number :
Provider Business Practice Location Address
First Line : 8316 PICARDY AVE
Second Line :
City : BATON ROUGE
State : LA
Zip : 70809-3686
Country : US
Telephone Number : 225-767-5032
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2026
Last Update Date : 02/16/2026

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