{
"Npi": {
"NPI": "1114258670",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "GORMAN",
"FirstName": "TERRI",
"MiddleName": "L.",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "L.C.S.W.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 681",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PENROSE",
"MailingAddressStateName": "CO",
"MailingAddressPostalCode": "81240-0681",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "719-784-7522",
"MailingAddressFaxNumber": "719-784-7522",
"FirstLinePracticeLocationAddress": "1335 PHAY AVE",
"SecondLinePracticeLocationAddress": "SUITE H",
"PracticeLocationAddressCityName": "CANON CITY",
"PracticeLocationAddressStateName": "CO",
"PracticeLocationAddressPostalCode": "81212-2334",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "719-784-7522",
"PracticeLocationAddressFaxNumber": "719-784-7522",
"EnumerationDate": "01/23/2010",
"LastUpdateDate": "12/01/2010",
"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": "993001",
"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}