Organization Active NPI

Dynamic Wellness Solutions, LLC

  • Adult Mental Health Clinic/Center
  • Wilton Manors, FL
National Provider Identifier
1548743024
Registry record updated Sep 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
DYNAMIC WELLNESS SOLUTIONS, LLC
Practice address
1881 NE 26TH St Ste 201a
Wilton Manors, FL 33305-1427
Phone
(195) 436-8581
NPI assigned
Sep 11, 2018
Last updated
Sep 11, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2018

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

Authorized official

Name
Grace Marquez, LMHC, MCAP
Title
Owner/Chief Executive Officer
Phone
(954) 368-5819

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU

Addresses

Primary practice location

1881 NE 26TH St Ste 201a
Wilton Manors, FL 33305-1427

Mailing address

1881 NE 26TH St Ste 201a
Wilton Manors, FL 33305-1427
Phone (195) 436-8581

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536624000000",
    "number": "1548743024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1881 NE 26TH ST STE 201A",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333051427",
            "telephone_number": "195-436-8581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 NE 26TH ST STE 201A",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333051427",
            "telephone_number": "195-436-8581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC WELLNESS SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-11",
        "last_updated": "2018-09-11",
        "status": "A",
        "authorized_official_last_name": "MARQUEZ",
        "authorized_official_first_name": "GRACE",
        "authorized_official_title_or_position": "OWNER/CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "954-368-5819",
        "authorized_official_credential": "LMHC, MCAP"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilton Manors, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; 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.