MEDICARE: MRS. MARGARET ANN LIVESAY MSSW/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	32966	TX

General Provider Information

NPI Number	:	1598849762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARGARET ANN LIVESAY MSSW/LCSW

Provider Business Mailing Address
First Line	:	2944 HEMPHILL ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76110-6501
Country	:	US
Telephone Number	:	817-239-1114
Fax Number	:	817-926-8983

Provider Business Practice Location Address
First Line	:	2944 HEMPHILL ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76110-6501
Country	:	US
Telephone Number	:	817-239-1114
Fax Number	:	817-926-8983

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

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	07/09/2007

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