{
"Npi": {
"NPI": "1063796092",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "PRESTON",
"FirstName": "MELISSA",
"MiddleName": "CLAIRE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "MA, NCC, RD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "975 LINCOLN ST",
"SecondLineMailingAddress": "SUITE 205",
"MailingAddressCityName": "DENVER",
"MailingAddressStateName": "CO",
"MailingAddressPostalCode": "80203-2725",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "303-489-9269",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "975 LINCOLN ST",
"SecondLinePracticeLocationAddress": "SUITE 205",
"PracticeLocationAddressCityName": "DENVER",
"PracticeLocationAddressStateName": "CO",
"PracticeLocationAddressPostalCode": "80203-2725",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "303-489-9269",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/10/2011",
"LastUpdateDate": "10/06/2014",
"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": "103523",
"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "133V00000X",
"TaxonomyName": "Registered Dietitian",
"LicenseNumber": "933352",
"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}