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1073029385 NPI number — CARREFOUR COUNSELING & PLAY THERAPY LLC

NPI Number: 1073029385
Health Care Provider/Practitioner: CARREFOUR COUNSELING & PLAY THERAPY LLC

Information about “1073029385” NPI (CARREFOUR COUNSELING & PLAY THERAPY LLC) exists in 1073029385 in HTML format HTML  |  1073029385 in plain Text format TXT  |  1073029385 in PDF (Portable Document Format) PDF  |  1073029385 in an XML format XML  formats.

NPI Number : 1073029385 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1073029385",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "CARREFOUR COUNSELING & PLAY THERAPY LLC",
    "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 768",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GALAX",
    "MailingAddressStateName": "VA",
    "MailingAddressPostalCode": "24333-0768",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "276-266-7513",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "205 W GRAYSON ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GALAX",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "24333-2811",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "276-383-0400",
    "PracticeLocationAddressFaxNumber": "855-877-4676",
    "EnumerationDate": "12/21/2017",
    "LastUpdateDate": "05/08/2018",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "BELCHER",
    "AuthorizedOfficialFirstName": "CHRISTOPHER",
    "AuthorizedOfficialMiddleName": "LEE",
    "AuthorizedOfficialTitle": "COUNSELOR/PRESIDENT",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "LPC",
    "AuthorizedOfficialTelephoneNumber": "276-266-7513",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "261QM0801X",
        "TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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