Provider Demographics
NPI:1437491214
Name:LIVINGSTON, LEKESHA RENE (APSW)
Entity Type:Individual
Prefix:MRS
First Name:LEKESHA
Middle Name:RENE
Last Name:LIVINGSTON
Suffix:
Gender:F
Credentials:APSW
Other - Prefix:
Other - First Name:LEKESHA
Other - Middle Name:RENE
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APSW
Mailing Address - Street 1:210 W CAPITOL DR
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53212-1123
Mailing Address - Country:US
Mailing Address - Phone:414-727-6320
Mailing Address - Fax:414-727-6321
Practice Address - Street 1:210 W CAPITOL DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53212-1123
Practice Address - Country:US
Practice Address - Phone:414-727-6320
Practice Address - Fax:414-727-6321
Is Sole Proprietor?:No
Enumeration Date:2013-03-20
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI127620-121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker