Provider Demographics
NPI:1124323290
Name:LIVESAY, LINDSEY A (LPC)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:A
Last Name:LIVESAY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4334 BRAMBLETON AVE
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-3405
Mailing Address - Country:US
Mailing Address - Phone:540-776-1943
Mailing Address - Fax:540-776-9646
Practice Address - Street 1:4334 BRAMBLETON AVE
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018
Practice Address - Country:US
Practice Address - Phone:540-776-1943
Practice Address - Fax:540-776-9646
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-20
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003188101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional