Basic Information
| Provider Information | |||||||||
| NPI: | 1346210457 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LIVENGOOD | ||||||||
| FirstName: | JANICE | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | PHD, HSP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2410 PATTERSON ST | ||||||||
| Address2: | SUITE 500 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372031551 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153279543 | ||||||||
| FaxNumber: | 6153278471 | ||||||||
| Practice Location | |||||||||
| Address1: | 4230 HARDING RD | ||||||||
| Address2: | SUITE 810 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372052013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153279543 | ||||||||
| FaxNumber: | 6153278471 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | P0001582 | TN | X | Behavioral Health & Social Service Providers | Psychologist | Clinical | 103TB0200X | 1582 | TN | X | Behavioral Health & Social Service Providers | Psychologist | Cognitive & Behavioral |
No ID Information.