Organization Active NPI

Dynamic Living Counseling

  • Community/Behavioral Health Agency
  • Tempe, AZ
National Provider Identifier
1184495269
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
DYNAMIC LIVING COUNSELING
Practice address
1340 E Broadway Rd Ste 107
Tempe, AZ 85282-1637
Phone
(602) 277-2112
Fax
(480) 383-6972
NPI assigned
Jan 9, 2024
Organization subpart
Yes
Parent organization
DYNAMIC LIVING COUNSELING INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mark A Thiele
Title
Ceo/Owner
Phone
(602) 277-2112

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1340 E Broadway Rd Ste 107
Tempe, AZ 85282-1637

Mailing address

1501 E Osborn Rd Ste 103
Phoenix, AZ 85014-5350
Phone (602) 277-2112

National Provider Directory

National Provider Directory
Tax ID family
Dynamic Living Counseling Inc2 organizations share this tax ID, including this one
Part of
Dynamic Living Counseling Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1340 E Broadway Rd
Ste 107
Tempe, AZ 85282
Phone (602) 277-2112

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1704758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704844800000",
    "number": "1184495269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 E OSBORN RD STE 103",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850145350",
            "telephone_number": "602-277-2112",
            "fax_number": "480-383-6972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 E BROADWAY RD STE 107",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852821637",
            "telephone_number": "602-277-2112",
            "fax_number": "480-383-6972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC LIVING COUNSELING",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DYNAMIC LIVING COUNSELING INC",
        "enumeration_date": "2024-01-09",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A",
        "authorized_official_last_name": "THIELE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "602-277-2112"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.