Individual
JASEN J LIVERMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
956 12TH ST, CODY, WY 82414-3602
(307) 355-9266
Mailing address
2305 GREEVER ST, CODY, WY 82414-9436
(307) 355-9266
(307) 568-2503
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-2245
WY
Other
Enumeration date
01/31/2021
Last updated
09/30/2025
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