Provider Demographics
NPI:1467704650
Name:LIV ASSOCIATES, INC.
Entity Type:Organization
Organization Name:LIV ASSOCIATES, INC.
Other - Org Name:LIVWELL ASSOCIATES, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MORAN
Authorized Official - Middle Name:08
Authorized Official - Last Name:GOTTESMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:215-394-8625
Mailing Address - Street 1:1200 OLD YORK RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WARMINSTER
Mailing Address - State:PA
Mailing Address - Zip Code:18974-2013
Mailing Address - Country:US
Mailing Address - Phone:215-394-8625
Mailing Address - Fax:215-933-6898
Practice Address - Street 1:1200 OLD YORK RD
Practice Address - Street 2:SUITE 101
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974
Practice Address - Country:US
Practice Address - Phone:215-394-8625
Practice Address - Fax:215-933-6898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-11
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty