Provider Demographics
NPI:1811347081
Name:LIVANIS BEHAVIORAL CONSULTING
Entity type:Organization
Organization Name:LIVANIS BEHAVIORAL CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST AND BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:LIVANIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, BCBA-D, LBA
Authorized Official - Phone:718-564-0237
Mailing Address - Street 1:3227 33RD ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106-2127
Mailing Address - Country:US
Mailing Address - Phone:718-564-0237
Mailing Address - Fax:
Practice Address - Street 1:3227 33RD ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11106-2127
Practice Address - Country:US
Practice Address - Phone:718-564-0237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-17
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020103TB0200X
NY020334103TC2200X
NY000501103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty