MR. JIMMIE R LIVESAY BCBA
NPI 1336260256
Psychologist - Intellectual and Developmental Disabilities in Jonesboro, IL
- Individual
- Male
- Psychologist
- Intellectual and Developmental Disabilit...
About JIMMIE LIVESAY
This page provides the complete NPI Profile along with additional information for Jimmie Livesay, a provider established in Jonesboro, Illinois with a medical specialization in Psychologist, focusing in intellectual and developmental disabilities . The healthcare provider is registered in the NPI registry with number 1336260256 assigned on April 2007. The practitioner's primary taxonomy code is 103TM1800X. The provider is registered as an individual and his NPI record was last updated 19 years ago.
- NPI
- 1336260256 Verify this NPI
- Provider Name
- MR. JIMMIE R LIVESAY BCBA
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 514 N MAIN ST JONESBORO, IL 62952
- Location Phone
- (618) 614-4265
- Mailing Address
- 514 N MAIN ST JONESBORO, IL 62952
- Mailing Phone
- (618) 614-4265
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 04-02-2007
- Last Update Date
- 07-08-2007
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychologist Intellectual and Developmental Disabilities
- Taxonomy Code
- 103TM1800X
- Type
- Behavioral Health & Social Service Providers
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1336260256, enumerated as an "individual" on April 02, 2007.
The provider is located at 514 N MAIN ST JONESBORO, IL 62952 and the phone number is (618) 614-4265.
Psychologist with taxonomy code 103TM1800X and a focus in Intellectual and Developmental Disabilities.
