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Deactivated NPI 1093483190 Deactivated / Inactive NPI Male Practitioner

Jake Lively , RBT

Behavior Technician • Franklin, IN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Jake Lively has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 02, 2021
NPI Deactivation Date May 14, 2024
Total Practice Duration ~3 Years of Practice (2021 – 2024)

Professional Overview & Biography Verified Profile Summary

Jake Lively, RBT was a registered Behavior Technician practicing in Franklin, IN. Throughout an active medical career spanning 3 years, Jake Lively provided care at the practice location at 2134 HOLIDAY LN until profile deactivation on 2024-05-14.

Practice Location & Contact Primary Location

Practice Address

2134 Holiday Ln

Franklin, IN 461312600

Telephone 3174748512
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Behavior Technician in Franklin, IN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 3.0 Yrs
Regional Practice Density
86 Specialists

Practicing in Franklin, IN (17083 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2021-09-02
Behavior Technician Primary Specialty

NUCC Taxonomy Code: 106S00000X

State License IN RBT-21-168409

The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Bruce Mckinney

Behavior Technician

NPI 1023814043
Haley Walsman

Behavior Technician

NPI 1053117085
Amber Vancleave

Behavior Technician

NPI 1093428971
Ashley Ferguson , RBT

Behavior Technician

NPI 1134925134

Registered Behavior Technician

Malea Brownfield , BCBA

Behavior Technician

NPI 1144998238

Board Certified Behavior Analyst

Jaycie Blanford , RBT

Behavior Technician

NPI 1184390015

Registered Behavior Technician

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
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Updated Practice Location June 19, 2025

Registered at 2134 HOLIDAY LN, FRANKLIN, IN 461312600 (Tel: 3174748512)

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Updated Business Mailing Address June 19, 2025

Registered at 1824 TOUBY PIKE STE B, KOKOMO, IN 469012573 (Tel: 7656287400)

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Provider Name / Credentials Updated June 19, 2025

Recorded as JAKE LIVELY, RBT

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 19, 2025

Behavior Technician (License #RBT-21-168409 in IN)

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NPI Profile Deactivated May 14, 2024

Record deactivated on May 14, 2024

NPI Profile Active September 02, 2021

NPI status registered as active in NPPES database

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Updated Practice Location September 02, 2021

Registered at 2134 HOLIDAY LN, FRANKLIN, IN 461312600 (Tel: 3174748512)

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Updated Business Mailing Address September 02, 2021

Registered at 1824 TOUBY PIKE STE B, KOKOMO, IN 469012573 (Tel: 7656287400)

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Provider Name / Credentials Updated September 02, 2021

Recorded as JAKE LIVELY, RBT

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Medical Taxonomy / Specialty Registered (Primary Specialty) September 02, 2021

Behavior Technician (License #RBT-21-168409 in IN)

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Initial NPI Registration & Enumeration September 02, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1093483190
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 02, 2021
Last Update: June 19, 2025
Deactivation Date: May 14, 2024
Sole Proprietor: No

Mailing Address

1824 Touby Pike Ste B

Kokomo, IN 469012573

Phone: 7656287400

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.