{
"Npi": {
"NPI": "1013662873",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "UPTON",
"FirstName": "LYNDSEY",
"MiddleName": "CLAIRE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "M.ED, NCC, PCA",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "FISHER",
"OtherFirstName": "LYNDSEY",
"OtherMiddleName": "CLAIRE",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "M.ED, NCC, PCA",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "9450 SW GEMINI DR",
"SecondLineMailingAddress": "PMB 62871",
"MailingAddressCityName": "BEAVERTON",
"MailingAddressStateName": "OR",
"MailingAddressPostalCode": "97008",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "971-832-9052",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "9450 SW GEMINI DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BEAVERTON",
"PracticeLocationAddressStateName": "OR",
"PracticeLocationAddressPostalCode": "97008",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "971-832-9052",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/19/2022",
"LastUpdateDate": "05/15/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "101YP2500X",
"TaxonomyName": "Professional Counselor",
"LicenseNumber": "R8240",
"LicenseNumberStateCode": "OR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}