Provider Demographics
NPI:1811203904
Name:LIVENGOOD, JAMIE DIANE (LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:DIANE
Last Name:LIVENGOOD
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 OVERBROOK RD
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-4309
Mailing Address - Country:US
Mailing Address - Phone:919-583-8337
Mailing Address - Fax:
Practice Address - Street 1:117 OVERBROOK RD
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-4309
Practice Address - Country:US
Practice Address - Phone:919-583-8337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7612101YP2500X
101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional