Provider Demographics
NPI:1487418828
Name:ELIZABETH HIATT LPC-MHSP LLC
Entity type:Organization
Organization Name:ELIZABETH HIATT LPC-MHSP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:LIVINGSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-588-4044
Mailing Address - Street 1:6906 KINGSTON PIKE STE 200
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-5704
Mailing Address - Country:US
Mailing Address - Phone:865-588-4044
Mailing Address - Fax:
Practice Address - Street 1:6906 KINGSTON PIKE STE 200
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5704
Practice Address - Country:US
Practice Address - Phone:865-588-4044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty