DR. DANITA LYNN LIVELY MD
NPI 1093799173
Psychiatry & Neurology - Child & Adolescent Psychiatry in Carmel, IN

Active since December 02, 2005Opted out of Medicare · through Jan 6, 2028
703 PRO-MED LN, CARMEL, IN 46032(317) 844-0055(317) 581-3918 Get Directions Write a Review

NPPES record last updated: January 6, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Danita Lynn Lively Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DANITA LYNN LIVELY MD (NPI 1093799173) is an individual child & adolescent psychiatry provider in Carmel, Indiana, licensed in Indiana (01031924A) and active in the NPI registry since December 2005. She has opted out of Medicare through January 6, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1093799173
Entity TypeIndividualFemale
Primary Taxonomy2084P0804X
Provider Legal NameDR. DANITA LYNN LIVELYCredential: MD
Location Address703 PRO-MED LNCarmel, IN 46032-5317
Mailing Address210 E 91st St, Suite CIndianapolis, IN 46240-1569
Fax(317) 581-3918
Sole ProprietorNo
Enumeration DateDecember 2, 2005
Last NPPES UpdateJanuary 6, 2020
NPI 1093799173 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
License Licensed in IN · 01031924A
Definition

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.

Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License 01031924A (IN)
703 PRO-MED LN, Carmel, IN 46032

Other Identifiers 1

Medicaid100352260IN

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Dr. Danita Lynn Lively Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 6, 2020 through January 6, 2028.

Opt-Out Effective DateJanuary 6, 2020
Opt-Out In Effect ThroughJanuary 6, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pharmacist
703 PRO-MED LN
CARMEL, IN 46032
Social Worker (Clinical)
703 PRO-MED LN, SUITE 200
CARMEL, IN 46032
Psychologist (Clinical)
703 PRO-MED LN, SUITE 200
CARMEL, IN 46032
Social Worker (Clinical)
703 PRO-MED LN, SUITE 200
CARMEL, IN 46032
Clinic/Center (Mental Health (Including Community Mental Health Center))
703 PRO-MED LN
CARMEL, IN 46032
Psychiatry & Neurology (Psychiatry)
703 PRO-MED LN, SUITE 200
CARMEL, IN 46032
Counselor (Mental Health)
703 PRO-MED LN
CARMEL, IN 46032
Clinical Nurse Specialist (Psychiatric/Mental Health, Adult)
703 PRO-MED LN, SUITE 200
CARMEL, IN 46032

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1093799173, enumerated as an "individual" on December 02, 2005.

The provider is located at 703 PRO-MED LN CARMEL, IN 46032 and the phone number is (317) 844-0055.

Psychiatry & Neurology with taxonomy code 2084P0804X and a focus in Child & Adolescent Psychiatry.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.