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General NPI Number Information
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NPI Number | 1891641338
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Entity Type | Organization
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Legal Business Name | BOUNTIFUL LIVING AND ASSISTANCE LLC
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Dates
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Enumeration Date | 03/06/2026
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Last Update Date | 03/06/2026
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Provider Practice Location Address
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Address Line | 5713 DREXEL AVE
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City | LITTLE ROCK
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State | AR
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Zip | 72209-8413
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Country | US
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Telephone | 501-396-9916
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Fax |
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Provider Business Mailing Address
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Address Line | 6834 CANTRELL RD STE 1648
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City | LITTLE ROCK
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State | AR
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Zip | 72207-4135
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Country | US
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Telephone | 501-353-8336
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHANIKA NICKELBERRY
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Credential |
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Telephone | 501-353-8336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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