Lively, Providence

Lively, Providence is an sole proprietor health care provider with primary practice located at 400 E Royal Ln Ste 290 , Irving TX 75039-3602. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Assistant Behavior Analyst, Behavioral Health & Social Service Providers / Behavioral Analyst. Behavioral Health & Social Service Providers / Behavioral Analyst is her primary health care specialty. Lively, Providence can be contacted via phone (855) 832-6727.

Contact Information

Primary practice address
400 E Royal Ln Ste 290 Irving TX 75039-3602
Phone: (855) 832-6727
Fax: (772) 675-9100
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Assistant Behavior Analyst 106E00000X 1-19-39960 Texas
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X

Profile Details

NPI number 1629726948
LBN Legal business name Lively, Providence
Credentials BCBA, LBA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 15th, 2022
Last updated Mar 15th, 2022 - 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.

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