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1033650114 NPI number — MISSION COUNSELING GROUP, PLLC

NPI Number: 1033650114
Health Care Provider/Practitioner: MISSION COUNSELING GROUP, PLLC

Information about “1033650114” NPI (MISSION COUNSELING GROUP, PLLC) exists in 1033650114 in HTML format HTML  |  1033650114 in plain Text format TXT  |  1033650114 in PDF (Portable Document Format) PDF  |  1033650114 in an XML format XML  formats.

NPI Number : 1033650114 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1033650114",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "MISSION COUNSELING GROUP, PLLC",
    "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": "PO BOX 700731",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MIAMI",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33170-0731",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "786-601-2608",
    "MailingAddressFaxNumber": "305-647-0250",
    "FirstLinePracticeLocationAddress": "27501 S DIXIE HWY",
    "SecondLinePracticeLocationAddress": "SUITE 403",
    "PracticeLocationAddressCityName": "NARANJA",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33032-8235",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "786-601-2608",
    "PracticeLocationAddressFaxNumber": "305-647-0250",
    "EnumerationDate": "03/09/2017",
    "LastUpdateDate": "03/09/2017",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "JEREZ",
    "AuthorizedOfficialFirstName": "SAMIR",
    "AuthorizedOfficialMiddleName": "G",
    "AuthorizedOfficialTitle": "MANAGER",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "LMHC, QS",
    "AuthorizedOfficialTelephoneNumber": "786-601-2608",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "103K00000X",
          "TaxonomyName": "Behavior Analyst",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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