Healthcare Provider Details

I. General information

NPI: 1780723213
Provider Name (Legal Business Name): JUDITH G LIVANT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 07/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 PARKVIEW PLAZA
MORRISTOWN NJ
07960
US

IV. Provider business mailing address

3 PARKVIEW PLAZA
MORRISTOWN NJ
07960
US

V. Phone/Fax

Practice location:
  • Phone: 973-971-0060
  • Fax:
Mailing address:
  • Phone: 973-971-0060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number37LC00014000
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37PC00009800
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00009800
License Number StateNJ

VIII. Authorized Official

Name: MS. JUDITH G LIVANT
Title or Position: SOLE PROPRIETOR OF LLC
Credential: LPC LCADC
Phone: 973-971-0060