Provider Demographics
NPI:1578171682
Name:LIV THERAPY LLC
Entity Type:Organization
Organization Name:LIV THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CAVALL
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:954-649-6592
Mailing Address - Street 1:4803 SEABERG RD
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33541-2862
Mailing Address - Country:US
Mailing Address - Phone:954-649-6592
Mailing Address - Fax:954-342-6582
Practice Address - Street 1:4803 SEABERG RD
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33541-2862
Practice Address - Country:US
Practice Address - Phone:954-649-6592
Practice Address - Fax:954-342-6582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-15
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty