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Individual

BENJAMIN P LIVESAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3220 WISCONSIN AVE STE C, JOPLIN, MO 64804-4074
(417) 347-7730
Mailing address
101 N MAIN ST, PO BOX #101, JOPLIN, MO 64802-2201

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MO
1041C0700X
Clinical Social Worker
118537
TX
1041C0700X
Clinical Social Worker
22305
OK
1041C0700X
Clinical Social Worker
28228
AR

Other

Enumeration date
09/05/2018
Last updated
04/30/2026
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