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NPI Code Detail

MEDICARE: LIVINIUS CHARLES PETERS BHRS

MEDICARE: LIVINIUS CHARLES PETERS BHRS
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
1101Y00000XCounselorOK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558656728
Entity Type Code : Individual
Provider Name (Legal Business Name) : LIVINIUS CHARLES PETERS BHRS
Provider Business Mailing Address
First Line : 1812 FOXFIRE RD
Second Line :
City : EDMOND
State : OK
Zip : 73003-6202
Country : US
Telephone Number : 405-509-1180
Fax Number :
Provider Business Practice Location Address
First Line : 1609 GREENBRIAR PL
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73159-7640
Country : US
Telephone Number : 405-735-3683
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2011
Last Update Date : 06/15/2011

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Directions to “ LIVINIUS CHARLES PETERS BHRS” Practice Location

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