{
"Npi": {
"NPI": "1114288461",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SMOTHERS",
"FirstName": "KENNETH",
"MiddleName": "JAY",
"NamePrefix": "MR.",
"NameSuffix": null,
"Credential": "M. ED., L.P.C.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "123 CREEK BEND LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "COLUMBUS",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78934-2052",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "979-885-2900",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "330 MAIN ST",
"SecondLinePracticeLocationAddress": "SUITE 7",
"PracticeLocationAddressCityName": "SEALY",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77474-2391",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "979-885-2900",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/04/2012",
"LastUpdateDate": "06/04/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "101YP2500X",
"TaxonomyName": "Professional Counselor",
"LicenseNumber": "10616",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}