MEDICARE: MS. EVE ELIZABETH LIEVONEN LCSW

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
1	1041C0700X	Clinical Social Worker	LCS15784	CA

General Provider Information

NPI Number	:	1356329791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. EVE ELIZABETH LIEVONEN LCSW

Provider Business Mailing Address
First Line	:	4 PONDERS END
Second Line	:
City	:	LAGUNA NIGUEL
State	:	CA
Zip	:	92677-4129
Country	:	US
Telephone Number	:	949-436-0861
Fax Number	:	949-481-8413

Provider Business Practice Location Address
First Line	:	1000 QUAIL ST
Second Line	:	SUITE # 240
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-2731
Country	:	US
Telephone Number	:	949-436-0861
Fax Number	:	949-481-8413

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2006
Last Update Date	:	07/08/2007

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