Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jateziah Lyerisa Lively

Individual provider Mental Health Counselor · NPI 1760302061

Jateziah Lyerisa Lively is a Mental Health Counselor in Louisville, Kentucky. Practices as a sole proprietor. Licensed in Kentucky.

Licensed in
KY
In the registry since
2026

Practice location Address checks out

914 Lily Creek Rd
Louisville, KY 40243-2815
Phone: (502) 291-4415
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 295156 (KY)

Record details

NPI number1760302061
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJuly 16, 2026
Last updated in NPPESJuly 17, 2026
Certification dateJuly 17, 2026

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