Provider Demographics
NPI:1558901744
Name:LIVISAY, MEGAN (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:MEGAN
Middle Name:
Last Name:LIVISAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 W HILLSBORO BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-1612
Mailing Address - Country:US
Mailing Address - Phone:954-596-5284
Mailing Address - Fax:
Practice Address - Street 1:700 W HILLSBORO BLVD STE 205
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-1612
Practice Address - Country:US
Practice Address - Phone:954-596-5284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-15
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW143521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical