| Dr. Livengood Psychology, Psyd, Pllc | |
|
1315 W 17th St Unit 15034 Panama City FL 32406-7702 | |
| (850) 276-6401 | |
| (850) 792-6916 |
| Full Name | Dr. Livengood Psychology, Psyd, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 1315 W 17th St Unit 15034, Panama City, Florida |
| Authorized Official Name and Position | Tara Livengood (PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 8502766401 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Livengood Psychology, Psyd, Pllc 1315 W 17th St Unit 15034 Panama City FL 32406-7702 Ph: (850) 276-6401 | Dr. Livengood Psychology, Psyd, Pllc 1315 W 17th St Unit 15034 Panama City FL 32406-7702 Ph: (850) 276-6401 |
| NPI Number | 1396464756 |
|---|---|
| Provider Enumeration Date | 08/26/2022 |
| Last Update Date | 02/12/2025 |
| Certification Date | 02/12/2025 |
| Medicare PECOS PAC ID | 6507241148 |
|---|---|
| Medicare Enrollment ID | O20220916002367 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396464756 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Tara Marie Livengood |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649750753 PECOS PAC ID: 7315322955 Enrollment ID: I20220916002712 |
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