Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | LNR1630411 | CA |
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | LNR1630411 | CA |
N | 225C00000X | Rehabilitation Counselor | LNR1630411 | CA |
NPI | 1124598644 |
---|---|
Provider Name | Kate Livingood |
First Address | Huntingtn Bch, CA 92647-5019 |
Second Address | Huntingtn Bch, CA 92647-5019 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/11/2018 |
Last Update Date | 10/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
LRN1630411 | CCAPP (01) | CA |