| Livewell Behavioral Health Counseling Center | |
|
1300 E Shaw Ave Suite 172 Fresno CA 93710-7917 | |
| (559) 472-3587 | |
| (559) 472-3587 |
| Full Name | Livewell Behavioral Health Counseling Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1300 E Shaw Ave, Fresno, California |
| Authorized Official Name and Position | Michelle Renee Mccoy (CLINICAL DIRECTOR) |
| Authorized Official Contact | 5595549710 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Livewell Behavioral Health Counseling Center 1300 E Shaw Ave Ste 149 Fresno CA 93710-7903 Ph: (559) 473-3632 | Livewell Behavioral Health Counseling Center 1300 E Shaw Ave Suite 172 Fresno CA 93710-7917 Ph: (559) 472-3587 |
| NPI Number | 1851756092 |
|---|---|
| Provider Enumeration Date | 12/15/2015 |
| Last Update Date | 02/15/2022 |
| Certification Date | 02/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851756092 | NPI | - | NPPES |
| 1649395419 | Other | CA | INDIVIDUAL NPI NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | 80212 (California) | Primary |
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