{
"Npi": {
"NPI": "1104494541",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "EARLE",
"FirstName": "DONNA",
"MiddleName": "GERMINO",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "MA., LPC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "EARLE",
"OtherFirstName": "DONNA",
"OtherMiddleName": "GERMINO",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "MA., LPC",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "401 N. CARROLL AVENUE",
"SecondLineMailingAddress": "SUITE 401",
"MailingAddressCityName": "SOUTHLAKE",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76092",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "214-336-4933",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3217 WILBARGER TRL",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SOUTHLAKE",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "76092-3331",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "214-336-4933",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/13/2021",
"LastUpdateDate": "04/30/2024",
"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": "82783",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}