Individual
MRS. ELLEN C LIVINGSTON
Active
Individual
MRS. ELLEN C LIVINGSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-C, LICSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
12723
MD
104100000X
Social Worker
LC50078096
DC
1041C0700X
Clinical Social Worker
Primary
12723
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20CVEC
CAREFIRST PREFERRED PROVI
MD
01
—
5472
CAREFIRST GHMSI PROVIDER
MD
01
—
7503874
AETNA EAP PROVIDER PIN
MD
Enumeration date
03/28/2007
Last updated
08/27/2008
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