{
"Npi": {
"NPI": "1023527454",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "SUSAN KEORTGE COOK, PH.D.",
"ParentOrgTIN": null,
"OrgName": "SUSAN KEORTGE COOK, PH.D.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2801 YOUNGFIELD ST.",
"SecondLineMailingAddress": "SUITE 300",
"MailingAddressCityName": "GOLDEN",
"MailingAddressStateName": "CO",
"MailingAddressPostalCode": "80401",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "303-205-8491",
"MailingAddressFaxNumber": "303-232-0384",
"FirstLinePracticeLocationAddress": "2801 YOUNGFIELD ST.",
"SecondLinePracticeLocationAddress": "SUITE 300",
"PracticeLocationAddressCityName": "GOLDEN",
"PracticeLocationAddressStateName": "CO",
"PracticeLocationAddressPostalCode": "80401",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "303-205-8491",
"PracticeLocationAddressFaxNumber": "303-232-0384",
"EnumerationDate": "09/28/2017",
"LastUpdateDate": "09/28/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "COOK",
"AuthorizedOfficialFirstName": "SUSAN",
"AuthorizedOfficialMiddleName": "KEORTGE",
"AuthorizedOfficialTitle": "CLINICAL PSYCHOLOGIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PH.D.",
"AuthorizedOfficialTelephoneNumber": "303-205-8491",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "103TC0700X",
"TaxonomyName": "Clinical Psychologist",
"LicenseNumber": "2696",
"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}