{
"Npi": {
"NPI": "1093238446",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "GILMORE",
"FirstName": "LOLITA",
"MiddleName": "RENEE'",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "LCSW",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "GILMORE-RANDALL",
"OtherFirstName": "LOLITA",
"OtherMiddleName": "R",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "DR. LOLITA GILMORE",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "201 GRACIE CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HARKER HEIGHTS",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76548-7481",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "254-781-9900",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "590 MEDICAL CENTER ROAD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FORT CAVAZOS",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "76544-4752",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "254-553-6830",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/18/2017",
"LastUpdateDate": "02/07/2025",
"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": "101YA0400X",
"TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
"LicenseNumber": "13716",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "CSW008749",
"LicenseNumberStateCode": "GA",
"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."
}
}
}
}