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NPI Code Detail

MEDICARE: MR. HARRY DOUGLAS LIVESAY LCSW

MEDICARE:  MR. HARRY DOUGLAS LIVESAY  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
11041C0700XClinical Social Worker26298TX

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 : 1972724631
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. HARRY DOUGLAS LIVESAY LCSW
Provider Business Mailing Address
First Line : 505 E PALM VALLEY BLVD STE 240
Second Line :
City : ROUND ROCK
State : TX
Zip : 78664-3043
Country : US
Telephone Number : 844-824-8775
Fax Number :
Provider Business Practice Location Address
First Line : 505 E PALM VALLEY BLVD STE 240
Second Line :
City : ROUND ROCK
State : TX
Zip : 78664-3043
Country : US
Telephone Number : 844-824-8775
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2007
Last Update Date : 11/04/2024

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Directions to “ MR. HARRY DOUGLAS LIVESAY LCSW” Practice Location

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