Provider Demographics
NPI:1578656302
Name:LIVINGSTON COUNTY
Entity type:Organization
Organization Name:LIVINGSTON COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY PUBLIC HEALTH DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:PERAINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-243-7270
Mailing Address - Street 1:4600 MILLENNIUM DR
Mailing Address - Street 2:
Mailing Address - City:GENESEO
Mailing Address - State:NY
Mailing Address - Zip Code:14454-1197
Mailing Address - Country:US
Mailing Address - Phone:585-243-7250
Mailing Address - Fax:585-243-7264
Practice Address - Street 1:4600 MILLENNIUM DR
Practice Address - Street 2:
Practice Address - City:GENESEO
Practice Address - State:NY
Practice Address - Zip Code:14454-1197
Practice Address - Country:US
Practice Address - Phone:585-243-7250
Practice Address - Fax:585-243-7264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYLMOtherBCBS INDEM PROV NUMBER
NY014006252OtherBCBS PROVIDER NUMBER
NY00357960Medicaid
NY01662211Medicaid
NY103061EUOtherPREF CARE PROVIDER NUMBER
NY01662211Medicaid