Lively, Danita Lynn
Lively, Danita Lynn is an individual health care provider with primary practice located at 703 Pro-Med Ln , Carmel IN 46032-5317. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry is her primary health care specialty. Lively, Danita Lynn can be contacted via phone (317) 844-0055.Contact Information
Primary practice address
703 Pro-Med Ln
Carmel IN 46032-5317
Phone: (317) 844-0055
Fax: (317) 581-3918
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 01031924A | Indiana |
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | 01031924A | Indiana |
Profile Details
NPI number | 1093799173 |
---|---|
LBN Legal business name | Lively, Danita Lynn |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Dec 2nd, 2005 |
Last updated | Jan 6th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1093799173 | NPPES |
Indiana | MEDICAID | 100352260 |
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