Provider Demographics
NPI:1346210457
Name:LIVENGOOD, JANICE M (PHD, HSP)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:M
Last Name:LIVENGOOD
Suffix:
Gender:F
Credentials:PHD, HSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2410 PATTERSON ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1551
Mailing Address - Country:US
Mailing Address - Phone:615-327-9543
Mailing Address - Fax:615-327-8471
Practice Address - Street 1:4230 HARDING RD
Practice Address - Street 2:SUITE 810
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2013
Practice Address - Country:US
Practice Address - Phone:615-327-9543
Practice Address - Fax:615-327-8471
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0001582103TC0700X
TN1582103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3684147Medicare ID - Type Unspecified