{
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"FirstLineMailingAddress": "1900 ALGUNO RD",
"SecondLineMailingAddress": "APT B",
"MailingAddressCityName": "AUSTIN",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78757-3221",
"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "12335 HYMEADOW DR",
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"PracticeLocationAddressCityName": "AUSTIN",
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"EnumerationDate": "11/01/2016",
"LastUpdateDate": "11/01/2016",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MEDLYN",
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"AuthorizedOfficialCredential": "LPC",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Professional Counselor",
"LicenseNumber": "70948",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}