| Doctor Name: | MR. ALFRED LIVINGSTON |
| NPI Number: | 1659773737 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CAADC |
| License Number: | C0124 |
| Business Practice Address: | 410 S Sherman St Fitzgerald, GA - 317503352 |
| Business Phone Number: | 2294260002 |
| Business Fax Number: | 2294260008 |
| Mailing Address: | 410 S Sherman St, FITZGERALD |
| State: | GA |
| Postal Code: | 317503352 |
| Phone Number: | 2294260002 |
| Fax Number: | 2294260008 |
| NPI Enumeration Date: | 09/20/2014 |
| NPI Last Update Date: | 09/20/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | C0124 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |