{
"Npi": {
"NPI": "1134088255",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "INFINITY WELLMINDS SERVICES 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": "4002 S M ST STE C",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TACOMA",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98418-3800",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "253-254-5213",
"MailingAddressFaxNumber": "253-237-9487",
"FirstLinePracticeLocationAddress": "4002 S M ST STE C",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "TACOMA",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98418-3800",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "253-254-5213",
"PracticeLocationAddressFaxNumber": "253-237-9487",
"EnumerationDate": "01/16/2026",
"LastUpdateDate": "01/16/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "OBINNA-IGBOKWE",
"AuthorizedOfficialFirstName": "CHRISTENCIA",
"AuthorizedOfficialMiddleName": "N",
"AuthorizedOfficialTitle": "MANAGING MEMBER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "APRN, PMHNP-BC",
"AuthorizedOfficialTelephoneNumber": "253-254-5213",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM0801X",
"TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}