Healthcare Provider Details

I. General information

NPI: 1689587313
Provider Name (Legal Business Name): PATIENCE LIVERMORE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 E LONG ST STE 3000
COLUMBUS OH
43203-1874
US

IV. Provider business mailing address

121 AVONDALE AVE
COLUMBUS OH
43222-1412
US

V. Phone/Fax

Practice location:
  • Phone: 614-300-2334
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2613629
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: