Provider Demographics
NPI:1659488740
Name:LIVINGSTON, ELLEN F (MS, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:F
Last Name:LIVINGSTON
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:F
Other - Last Name:LIVINGSTON-ROSTAFIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS,LPC, NCC
Mailing Address - Street 1:201 COMMONS PARK S UNIT 1410
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-7071
Mailing Address - Country:US
Mailing Address - Phone:203-491-0402
Mailing Address - Fax:
Practice Address - Street 1:201 COMMONS PARK S UNIT 1410
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-7071
Practice Address - Country:US
Practice Address - Phone:203-491-0402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002269101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health