MR. JIMMIE R LIVESAY (NPI# 1336260256) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336260256 |
| Entity Type | Individual |
| Full Name | MR. JIMMIE R LIVESAY |
| Credential | BCBA |
| Practice Address |
514 N Main St Jonesboro IL 62952-1800 |
| Practice Telephone | 6186144265 |
| Mailing Telephone | 6186144265 |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TM1800X |
Psychologist Specialization: Mental Retardation & Developmental Disabilities |
Behavioral Health & Social Service Providers |
| Street Address |
514 N MAIN ST |
| City | JONESBORO |
| State | IL |
| Zip Code | 62952-1800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588120463 | Cody Hubble | Physical Therapist | 995 Route 127 South, Jonesboro, IL 62952 | 2019-02-15 |
| 1043464746 | Petersen Health Operations, LLC | Skilled Nursing Facility | 995 State Rt 127 S, Jonesboro, IL 62952 | 2008-11-07 |
| 1619094364 | Jonesboro Cc School Dist 43 | Clinic/Center | 309 Cook Ave, Jonesboro, IL 62952 | 2007-03-26 |
| 1861588097 | County of Union | Ambulance | 204 W Mississippi St, Jonesboro, IL 62952-0037 | 2006-10-05 |
| 1568686947 | Lincoln Square | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 202 South Main St, Jonesboro, IL 62952-0112 | 2007-04-13 |
| 1083692347 | Witold Szyfer | Internal Medicine | 301 S Orange St, Jonesboro, IL 62952-1104 | 2006-01-06 |
| 1780133397 | David Adams | Contractor | 308 Willards Ferry Rd, Jonesboro, IL 62952-1113 | 2016-09-23 |
| 1770009417 | Allison Bean | Speech-Language Pathologist | 309 Cook Ave, Jonesboro, IL 62952-1118 | 2017-08-15 |
| 1285805705 | Jonesboro School District 43 | Clinic/Center | 309 Cook Ave, Jonesboro, IL 62952-1118 | 2008-03-13 |
| 1598702862 | Petersen Health Properties, LLC | Skilled Nursing Facility | 995 State Route 127 S, Box B, Jonesboro, IL 62952-2423 | 2006-06-02 |
| Find all providers in zip 62952 | ||||
| Taxonomy Code | 103TM1800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Mental Retardation & Developmental Disabilities |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194296582 | Joshua E Green | Psychologist | 2721 W Belmont Ave Apt 1, Chicago, IL 60618-5914 | 2018-12-10 |
| 1891205605 | Delorean Mckinney | Psychologist | 4031 Dayton Ave, Mchenry, IL 60050 | 2017-10-06 |
| 1447598305 | Alison Lee May | Psychologist | 4736 Washington St, Skokie, IL 60076-2573 | 2013-01-27 |
| 1477818359 | Susan Elizabeth Reed | Psychologist | 2434 W Byron St, Chicago, IL 60618-3710 | 2012-07-07 |
| 1134392590 | Jennifer Lynne Klapatch | Psychologist | 928 W Eastwood Ave, Chicago, IL 60640-5108 | 2008-04-08 |
| 1285803114 | Michael E May | Psychologist | 208 Breeze St, Carterville, IL 62918-2358 | 2008-02-25 |
| 1386812782 | Vicky James | Psychologist | 11600 Francis Rd, Mokena, IL 60448-2440 | 2008-02-19 |
| 1700054988 | Erika Marie Winston | Psychologist | 3100 S Central Ave, Cicero, IL 60804-3956 | 2008-02-11 |
| 1245411156 | Trista D. Robinson | Psychologist | 100 Forest Pl, Unit P36, Oak Park, IL 60301-1145 | 2007-11-19 |
| 1942489315 | Emily Guinta | Psychologist | 3135 Concord Ln, Wadsworth, IL 60083-8938 | 2007-11-01 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MR. JIMMIE R LIVESAY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.