Provider Demographics
NPI:1881907889
Name:LIVINGSTON, SHERYL BAHE (MA, LMHC)
Entity type:Individual
Prefix:MS
First Name:SHERYL
Middle Name:BAHE
Last Name:LIVINGSTON
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
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Mailing Address - Street 1:211 W MESA AVE
Mailing Address - Street 2:
Mailing Address - City:GALLUP
Mailing Address - State:NM
Mailing Address - Zip Code:87301-6382
Mailing Address - Country:US
Mailing Address - Phone:505-237-0061
Mailing Address - Fax:505-237-0068
Practice Address - Street 1:516 EAST NIZHONI BLVD.
Practice Address - Street 2:
Practice Address - City:GALLUP
Practice Address - State:NM
Practice Address - Zip Code:87301-1337
Practice Address - Country:US
Practice Address - Phone:505-722-1000
Practice Address - Fax:505-722-1705
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0135541101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health