Individual
MARK A LIVINGSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCIT, SAC
Contact information
Practice address
2701 S CHASE AVE STE C, MILWAUKEE, WI 53207-1482
(414) 389-6450
Mailing address
7216 S. 37TH PLACE, FRANKLIN, WI 53132
(414) 793-3297
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16622-130
WI
101YP2500X
Professional Counselor
Primary
1724-226
WI
Other
Enumeration date
06/26/2012
Last updated
04/22/2014
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