Healthcare Provider Details

I. General information

NPI: 1043495104
Provider Name (Legal Business Name): LIVE MORE SIMPLY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2008
Last Update Date: 07/25/2022
Certification Date: 07/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5454 LA SIERRA DR. STE 201
DALLAS TX
75231
US

IV. Provider business mailing address

7615 RIVERBROOK DR
DALLAS TX
75230-4460
US

V. Phone/Fax

Practice location:
  • Phone: 888-923-2256
  • Fax: 888-923-2256
Mailing address:
  • Phone: 469-236-2620
  • Fax: 888-923-2256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number32635
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number32635
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number32635
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number32635
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number32635
License Number StateTX
# 6
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number32635
License Number StateTX

VIII. Authorized Official

Name: STUART N ROBINSON
Title or Position: PRESIDENT - LICENSED PSYCHOLOGIST
Credential: PHD
Phone: 888-923-2256