Provider Demographics
NPI:1407061153
Name:LIVINGSTON, STEVE ELDON (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVE
Middle Name:ELDON
Last Name:LIVINGSTON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2591 N OCEANSHORE BLVD
Mailing Address - Street 2:
Mailing Address - City:FLAGLER BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32136-2725
Mailing Address - Country:US
Mailing Address - Phone:850-559-2579
Mailing Address - Fax:
Practice Address - Street 1:2591 N OCEANSHORE BLVD
Practice Address - Street 2:
Practice Address - City:FLAGLER BEACH
Practice Address - State:FL
Practice Address - Zip Code:32136-2725
Practice Address - Country:US
Practice Address - Phone:850-559-2579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 0879101YM0800X
FLMT 1041106H00000X
GAMFT 877106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health