Provider Demographics
NPI:1215657234
Name:LIVINGTHRIVINGFORWARD
Entity type:Organization
Organization Name:LIVINGTHRIVINGFORWARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH PROFESSIONAL
Authorized Official - Prefix:
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:918-406-2679
Mailing Address - Street 1:1233 N CEDAR ST UNIT 252
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-5149
Mailing Address - Country:US
Mailing Address - Phone:918-406-2679
Mailing Address - Fax:
Practice Address - Street 1:637 E 57 STREET N
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74126
Practice Address - Country:US
Practice Address - Phone:918-406-2679
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-30
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty