1033954045 NPI number — LAURA ELLEN MARKLAND M.E.D, QMHP-C/A, C.T

NPI Number: 1033954045
Health Care Provider/Practitioner: LAURA ELLEN MARKLAND M.E.D, QMHP-C/A, C.T

NPI Number : 1033954045 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1033954045",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MARKLAND",
    "FirstName": "LAURA",
    "MiddleName": "ELLEN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "M.E.D, QMHP-C/A, C.T",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1500 S DOUGLAS RD STE 230",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CORAL GABLES",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33134-4108",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "844-244-1818",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "348 SOUTHPORT CIR STE 101",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "VIRGINIA BEACH",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "23452-1181",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "844-745-2301",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/01/2024",
    "LastUpdateDate": "09/30/2024",
    "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": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "0732002204",
          "LicenseNumberStateCode": "VA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "0733000690",
          "LicenseNumberStateCode": "VA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "106S00000X",
          "TaxonomyName": "Behavior Technician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}