{
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"LastName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "611 BELMONT AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "YOUNGSTOWN",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "44502-1037",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "330-744-2991",
"MailingAddressFaxNumber": "330-744-2893",
"FirstLinePracticeLocationAddress": "611 BELMONT AVE",
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"PracticeLocationAddressCityName": "YOUNGSTOWN",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "330-744-2991",
"PracticeLocationAddressFaxNumber": "330-744-2893",
"EnumerationDate": "04/13/2006",
"LastUpdateDate": "01/20/2017",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KENNEDY",
"AuthorizedOfficialFirstName": "BRIAN",
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"AuthorizedOfficialTelephoneNumber": "330-744-2991",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}