Life Dynamics LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

2011 Issued in OR

Legal business name

LIFE DYNAMICS LLC

Practice address

2100 NE Neff Rd Ste B
Bend, OR 97701-6213

Phone

(541) 647-2132

Fax

(541) 728-0109

NPI assigned

Feb 13, 2012

Organization subpart

No

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

Authorized official

Name

Elaine Michele Brown, RN PMHNP-BC ARNP

Title

LLC Sole Member

Phone

(541) 771-1548

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1329091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329091200000",
    "number": "1790058311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 NE NEFF RD STE B",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016213",
            "telephone_number": "541-647-2132",
            "fax_number": "541-728-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 NE NEFF RD STE B",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016213",
            "telephone_number": "541-647-2132",
            "fax_number": "541-728-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE DYNAMICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-13",
        "last_updated": "2012-02-13",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_middle_name": "MICHELE",
        "authorized_official_title_or_position": "LLC SOLE MEMBER",
        "authorized_official_telephone_number": "541-771-1548",
        "authorized_official_credential": "RN PMHNP-BC ARNP"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "OR",
            "license": "2011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Lieber, D.O.
• Bari Liebowitz, DC
• Brandon W Lien, CADC-I
• Liesl Farnsworth, PHD, LPC
• Life Balance Bend LLC
• Life Works of Central Oregon, LLC
• Lifesource Therapy LLC
• Lifestyle Medicine of Central Oregon, PC
• Lifetime Vision Care
• Lifetime Vision Care LLC

• Adult Mental Health Clinic/Center in Bend, OR
• Providers in Bend, OR by specialty
• Adult Mental Health Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2012; 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.