Healthcare Provider Details

I. General information

NPI: 1952206088
Provider Name (Legal Business Name): KATHERINE LIVINGSTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 EOFF ST
WHEELING WV
26003-3807
US

IV. Provider business mailing address

121 POPLAR AVE
WHEELING WV
26003-6059
US

V. Phone/Fax

Practice location:
  • Phone: 304-810-2116
  • Fax:
Mailing address:
  • Phone: 304-639-5302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberBP00946189
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: