NPI Code Detail JSON Logo

1053805945 NPI number — THIRD EYE COUNSELING INC.

NPI Number: 1053805945
Health Care Provider/Practitioner: THIRD EYE COUNSELING INC.

Information about “1053805945” NPI (THIRD EYE COUNSELING INC.) exists in 1053805945 in HTML format HTML  |  1053805945 in plain Text format TXT  |  1053805945 in PDF (Portable Document Format) PDF  |  1053805945 in an XML format XML  formats.

NPI Number : 1053805945 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1053805945",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "THIRD EYE COUNSELING INC.",
    "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 95",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "AURORA",
    "MailingAddressStateName": "ME",
    "MailingAddressPostalCode": "04408-0095",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "207-370-9397",
    "MailingAddressFaxNumber": "802-332-3142",
    "FirstLinePracticeLocationAddress": "2821 MARIAVILLE RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MARIAVILLE",
    "PracticeLocationAddressStateName": "ME",
    "PracticeLocationAddressPostalCode": "04605-7205",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "207-370-9397",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/14/2018",
    "LastUpdateDate": "05/12/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "GULOWSEN",
    "AuthorizedOfficialFirstName": "NICHOLE",
    "AuthorizedOfficialMiddleName": "E",
    "AuthorizedOfficialTitle": "PRESIDENT / MH & SA COUNSELOR",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "LCSW, CCS",
    "AuthorizedOfficialTelephoneNumber": "207-370-9397",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101Y00000X",
          "TaxonomyName": "Counselor",
          "LicenseNumber": "LC16682",
          "LicenseNumberStateCode": "ME",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YA0400X",
          "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
          "LicenseNumber": "LC16682",
          "LicenseNumberStateCode": "ME",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "LC16682",
          "LicenseNumberStateCode": "ME",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "LC16682",
          "LicenseNumberStateCode": "ME",
          "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."
        },
        {
          "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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