{
"Npi": {
"NPI": "1104109743",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CONNOLE",
"FirstName": "MARAH",
"MiddleName": "LYNN",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "MS, LCPC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 267",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HELENA",
"MailingAddressStateName": "MT",
"MailingAddressPostalCode": "59624",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "406-518-1165",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2728 COLONIAL DR STE 202",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HELENA",
"PracticeLocationAddressStateName": "MT",
"PracticeLocationAddressPostalCode": "59601-4922",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "406-518-1165",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/20/2011",
"LastUpdateDate": "06/26/2023",
"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": "101YP2500X",
"TaxonomyName": "Professional Counselor",
"LicenseNumber": "SWP-LCPC-LIC-7710",
"LicenseNumberStateCode": "MT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}