Organization
DYNAMIC LIVING COUNSELING
Active
Parent organization
DYNAMIC LIVING COUNSELING INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
DYNAMIC LIVING COUNSELING INC
Authorized official
MARK A THIELE (CEO/OWNER)
(602) 277-2112
Entity
Organization
Contact information
Practice address
1340 E BROADWAY RD STE 107, TEMPE, AZ 85282-1637
(602) 277-2112
(480) 383-6972
Mailing address
1501 E OSBORN RD STE 103, PHOENIX, AZ 85014-5350
(602) 277-2112
(480) 383-6972
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/09/2024
Last updated
01/10/2024
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