Lively-Pagliuca, Jennifer Nycole
Lively-Pagliuca, Jennifer Nycole is an sole proprietor health care provider with primary practice located at 4700 Las Vegas Blvd N , Nellis Afb NV 89191-6600. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Social Worker is her primary health care specialty. Lively-Pagliuca, Jennifer Nycole can be contacted via phone (702) 653-2273.Contact Information
Primary practice address
4700 Las Vegas Blvd N
Nellis Afb NV 89191-6600
Phone: (702) 653-2273
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 00758-C | Nevada |
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | 8013-S | Nevada |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | IC-1311 | Nevada |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 9561-C | Nevada |
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | 9561-C | Nevada |
Profile Details
| NPI number | 1801358817 |
|---|---|
| LBN Legal business name | Lively-Pagliuca, Jennifer Nycole |
| Credentials | LCSW, CADC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 1st, 2019 |
| Last updated | Aug 14th, 2023 - about 2 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 | 1801358817 | NPPES |
| Nevada | Other | 00758-C | CADC |
| Nevada | Other | 9561-C | CADC |
| Nevada | MEDICAID | 250002931 | CADC |
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