NPIMap

Organization Active NPI

Dynamic Intervention, LLC

  • Clinical Social Worker
  • Wappingers Falls, NY
National Provider Identifier
1942793252
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R056489 Issued in NY
Legal business name
DYNAMIC INTERVENTION, LLC
Practice address
3 Market St
Wappingers Falls, NY 12590-2301
Phone
(845) 702-1042
Fax
(845) 709-8434
NPI assigned
Jun 11, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Authorized official

Name
Jacqueline B Muller, LCSW-RNPI 1013002617
Title
Owner
Phone
(845) 702-1042

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X R056489 NY Primary

Addresses

Primary practice location

3 Market St
Wappingers Falls, NY 12590-2301

Mailing address

3 Market St
Wappingers Falls, NY 12590-2301
Phone (845) 702-1042

Other identifiers 1

IdentifierTypeStateIssuer
02869556MedicaidNY

Other names 2

  • Dynamic Intervention, LLC Former legal business name
  • Jacqueline Muller Other name

National Provider Directory

National Provider Directory

Locations

9 Arch St
Pawling, NY 12564

3 Market St
Wappingers Falls, NY 12590
Phone (845) 321-5644

2653 E Main St
Wappingers Falls, NY 12590
Phone (845) 297-8000

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1942793252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MARKET ST",
            "city": "WAPPINGERS FALLS",
            "state": "NY",
            "postal_code": "125902301",
            "telephone_number": "845-702-1042",
            "fax_number": "845-709-8434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MARKET ST",
            "city": "WAPPINGERS FALLS",
            "state": "NY",
            "postal_code": "125902301",
            "telephone_number": "845-702-1042",
            "fax_number": "845-709-8434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC INTERVENTION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-11",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A",
        "authorized_official_last_name": "MULLER",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-702-1042",
        "authorized_official_credential": "LCSW-R"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R056489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02869556",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dynamic Intervention, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Dynamic Intervention, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Jacqueline Muller",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wappingers Falls, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.