NPIMap

Organization Active NPI

Liv Well Behavioral

  • Community/Behavioral Health Agency
  • Mesa, AZ
National Provider Identifier
1497509509
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
LIV WELL BEHAVIORAL
Practice address
2150 S Country Club Dr Ste 27
Mesa, AZ 85210-6860
Phone
(602) 856-6535
NPI assigned
Apr 15, 2024
Organization subpart
Yes
Parent organization
LIV WELL BEHAVIORALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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

Authorized official

Name
Mr. Daniel Gonzalez
Title
Chief Executive Officer
Phone
(480) 522-4268

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2150 S Country Club Dr Ste 27
Mesa, AZ 85210-6860

Mailing address

2150 S Country Club Dr Ste 27
Mesa, AZ 85210-6860

Other identifiers 2

IdentifierTypeStateIssuer
BH9812OtherAZADHS
180933MedicaidAZ

National Provider Directory

National Provider Directory
Tax ID family
Liv Well Behavioral4 organizations share this tax ID, including this one
Part of
Liv Well Behavioral

Other organizations with this tax ID 3

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

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": "1713139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758499200000",
    "number": "1497509509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 S COUNTRY CLUB DR STE 27",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 S COUNTRY CLUB DR STE 27",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106860",
            "telephone_number": "602-856-6535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIV WELL BEHAVIORAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIV WELL BEHAVIORAL",
        "enumeration_date": "2024-04-15",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "480-522-4268",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADHS",
            "identifier": "BH9812",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180933",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; 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.