Active NPI
Kimberly Lively, PHD
- Psychologist
- Eugene, OR
National Provider Identifier
1295825933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1131
- Practice address
- 2506 Hawkins LN
Eugene, OR 97405-1203 - Phone
- (541) 683-3558
- Fax
- (541) 683-3558
- NPI assigned
- Oct 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1131 | OR | Primary |
Addresses
Primary practice location
2506 Hawkins LN
Eugene, OR 97405-1203
Mailing address
2506 Hawkins LN
Eugene, OR 97405-1203
Phone (541) 683-3558
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1131 | OR | MD | Naturopath |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383264000000",
"number": "1295825933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2506 HAWKINS LN",
"city": "EUGENE",
"state": "OR",
"postal_code": "974051203",
"telephone_number": "541-683-3558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2506 HAWKINS LN",
"city": "EUGENE",
"state": "OR",
"postal_code": "974051203",
"telephone_number": "541-683-3558",
"fax_number": "541-683-3558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIVELY",
"first_name": "KIMBERLY",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-13",
"last_updated": "2013-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OR",
"license": "1131",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.