Proactive Living, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

PROACTIVE LIVING, LLC

Practice address

2520 S 5TH Ave
Pocatello, ID 83204-1923

Phone

(208) 233-5433

Fax

(877) 284-2783

NPI assigned

Apr 4, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Steven McKee, LCSW

Title

Owner

Phone

(208) 233-5433

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1712188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712188800000",
    "number": "1063264778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 S 5TH AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832041923",
            "telephone_number": "208-233-5433",
            "fax_number": "877-284-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 S 5TH AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832041923",
            "telephone_number": "208-233-5433",
            "fax_number": "877-284-2783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-04",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A",
        "authorized_official_last_name": "MCKEE",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-233-5433",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.