| Dynamic Living Counseling Inc | |
|
1501 E Osborn Rd Ste 103 Phoenix AZ 85014 | |
| (602) 277-2112 | |
| (602) 294-6636 |
| Full Name | Dynamic Living Counseling Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1501 E Osborn Rd, Phoenix, Arizona |
| Authorized Official Name and Position | Mark Adam Thiele (CEO/OWNER) |
| Authorized Official Contact | 6022772112 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dynamic Living Counseling Inc 1501 E Osborn Rd Ste 103 Phoenix AZ 85014-5350 Ph: (026) 277-2112 | Dynamic Living Counseling Inc 1501 E Osborn Rd Ste 103 Phoenix AZ 85014 Ph: (602) 277-2112 |
| NPI Number | 1326572397 |
|---|---|
| Provider Enumeration Date | 04/17/2017 |
| Last Update Date | 07/02/2024 |
| Certification Date | 07/02/2024 |
| Medicare PECOS PAC ID | 4385164052 |
|---|---|
| Medicare Enrollment ID | O20250225001800 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326572397 | NPI | - | NPPES |
| Provider Name | Christopher Michael Holcomb |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912591793 PECOS PAC ID: 4385164078 Enrollment ID: I20250225002392 |
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