{
"Npi": {
"NPI": "1104408947",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BENSON",
"FirstName": "ASHLEY",
"MiddleName": "VERONICA",
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "MAY",
"OtherFirstName": "ASHLEY",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "260 2ND AVENUE CT SW",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RICE",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "56367-8827",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "708-586-2604",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "11301 S HARLEM AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WORTH",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60482-2001",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "708-586-2604",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/21/2021",
"LastUpdateDate": "10/20/2025",
"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": "103K00000X",
"TaxonomyName": "Behavior Analyst",
"LicenseNumber": "LBA0168",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}