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General NPI Number Information
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NPI Number | 1164677431
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Entity Type | Individual
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Provider Name | BRIAN LIVELSBERGER LCMFT
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Gender | Male
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Dates
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Enumeration Date | 11/29/2008
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Last Update Date | 12/01/2020
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Provider Practice Location Address
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Address Line | 4405 E WEST HWY STE 207
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City | BETHESDA
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State | MD
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Zip | 20814-4464
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Country | US
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Telephone | 240-452-0746
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Fax |
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Provider Business Mailing Address
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Address Line | 10315 JULEP AVE
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City | SILVER SPRING
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State | MD
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Zip | 20902-3861
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Country | US
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Telephone | 301-704-9948
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LCM356
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License Number State | MD
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