NPI Code Detail JSON Logo

1104925296 NPI number — GAILANE MARIE SPURGEON LPC

NPI Number: 1104925296
Health Care Provider/Practitioner: GAILANE MARIE SPURGEON LPC

Information about “1104925296” NPI (GAILANE MARIE SPURGEON LPC) exists in 1104925296 in HTML format HTML  |  1104925296 in plain Text format TXT  |  1104925296 in PDF (Portable Document Format) PDF  |  1104925296 in an XML format XML  formats.

NPI Number : 1104925296 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1104925296",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SPURGEON",
    "FirstName": "GAILANE",
    "MiddleName": "MARIE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LPC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "15 TONTO CIR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "VICTORIA",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "77904-1205",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1501 E MOCKINGBIRD LN",
    "SecondLinePracticeLocationAddress": "SUITE 262",
    "PracticeLocationAddressCityName": "VICTORIA",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "77904-2139",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "361-570-8900",
    "PracticeLocationAddressFaxNumber": "361-570-8903",
    "EnumerationDate": "09/22/2006",
    "LastUpdateDate": "07/08/2007",
    "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": "12048",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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