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Individual

JAY STEWART LIVINGSTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS, LPC, SAC

Contact information

Practice address
421 NEBRASKA ST, DOOR COUNTY DEPARTMENT OF COMMUNITY PROGRAMS, STURGEON BAY, WI 54235-2225
(920) 746-2345
(920) 746-2439
Mailing address
421 NEBRASKA ST, DOOR COUNTY DEPARTMENT OF COMMUNITY PROGRAMS, STURGEON BAY, WI 54235-2225
(920) 746-2345
(920) 746-2439

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2583
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39731200
WI
Enumeration date
07/22/2006
Last updated
05/10/2011
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