Provider Demographics
NPI:1194817288
Name:LIVINGSTON, CINDY JANE (LISW)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:JANE
Last Name:LIVINGSTON
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4041 W SYLVANIA AVE STE LL2
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4465
Mailing Address - Country:US
Mailing Address - Phone:419-356-7715
Mailing Address - Fax:877-622-7635
Practice Address - Street 1:4041 W SYLVANIA AVE STE LL2
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4465
Practice Address - Country:US
Practice Address - Phone:419-724-4233
Practice Address - Fax:877-622-7635
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH101YM0800X, 101YP1600X
OHI00096141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral