NPI Code Detail JSON Logo

1114894821 NPI number — INNERTHREAD PLLC

NPI Number: 1114894821
Health Care Provider/Practitioner: INNERTHREAD PLLC

Information about “1114894821” NPI (INNERTHREAD PLLC) exists in 1114894821 in HTML format HTML  |  1114894821 in plain Text format TXT  |  1114894821 in PDF (Portable Document Format) PDF  |  1114894821 in an XML format XML  formats.

NPI Number : 1114894821 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1114894821",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "INNERTHREAD PLLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "283 MENDENHALL RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WOLF POINT",
    "MailingAddressStateName": "MT",
    "MailingAddressPostalCode": "59201-7128",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "406-688-9740",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "406 MAIN ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WOLF POINT",
    "PracticeLocationAddressStateName": "MT",
    "PracticeLocationAddressPostalCode": "59201-1534",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "406-688-9740",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/20/2025",
    "LastUpdateDate": "10/20/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "LICCIARDI",
    "AuthorizedOfficialFirstName": "CORDIE",
    "AuthorizedOfficialMiddleName": "M",
    "AuthorizedOfficialTitle": "MANAGER/ CREDENTIAL SPECIALIST",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "701-580-4091",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "101YA0400X",
        "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
      }
    }
  }
}
                
            

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