Mr. George Livengood, MFT52124
Mr. George Livengood, MFT52124 is a Marriage and Family Therapist in Lake Balboa, California. Qualified in 2009, 17 years ago. Practices with Sud Specialty Group - Ca, a 499-clinician group and accepts Medicare assignment. Licensed in California.
- Years since qualifying
- 17
- Licensed in
- CA
- In the registry since
- 2021
Practice location Address checks out
6714 Balboa Blvd Apt 2Lake Balboa, CA 91406-5570
Phone: (917) 674-3459
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Marriage & Family Therapist (primary) | Taxonomy 106H00000X · Licence 52124 (CA) |
|---|
Record details
| NPI number | 1962093625 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | MFT52124 |
| Sole proprietor | Yes |
| NPI enumerated | January 26, 2021 |
| Last updated in NPPES | January 26, 2021 |
| Certification date | January 26, 2021 |
Medicare enrollment
| Medicare specialty | MARRIAGE AND FAMILY THERAPIST |
|---|---|
| Medical school | OTHER |
| Graduated | 2009 (17 years in practice) |
| Group practice | Sud Specialty Group - Ca — 499 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
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