{
"Npi": {
"NPI": "1033359435",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LILES COUNSELING PROFESSIONAL LIMITED LIABILITY COMPANY",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
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"OtherNamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "10486 BURGESS RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TEMPLE",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76501-7371",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "254-624-6755",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1000 W STATE HIGHWAY 6",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WOODWAY",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "76712-3786",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "254-776-0001",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/24/2009",
"LastUpdateDate": "02/24/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LILES",
"AuthorizedOfficialFirstName": "JAMES",
"AuthorizedOfficialMiddleName": "AYDEN",
"AuthorizedOfficialTitle": "MANAGING MEMBER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LPC",
"AuthorizedOfficialTelephoneNumber": "254-624-6755",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": "63247",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}