Provider Demographics
NPI:1962534610
Name:LIVINGSTON, DARREN THOMASINA (MSW LCSW P)
Entity type:Individual
Prefix:MS
First Name:DARREN
Middle Name:THOMASINA
Last Name:LIVINGSTON
Suffix:
Gender:F
Credentials:MSW LCSW P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 751803
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1803
Mailing Address - Country:US
Mailing Address - Phone:336-474-8921
Mailing Address - Fax:
Practice Address - Street 1:309 PINEYWOOD RD
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:NC
Practice Address - Zip Code:27360-3438
Practice Address - Country:US
Practice Address - Phone:336-474-8921
Practice Address - Fax:336-474-8923
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0038151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical