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1144565284 NPI number — LEEANN ROCHELLE GUMULAUSKAS

NPI Number: 1144565284
Health Care Provider/Practitioner: LEEANN ROCHELLE GUMULAUSKAS

Information about “1144565284” NPI (LEEANN ROCHELLE GUMULAUSKAS) exists in 1144565284 in HTML format HTML  |  1144565284 in plain Text format TXT  |  1144565284 in PDF (Portable Document Format) PDF  |  1144565284 in an XML format XML  formats.

NPI Number : 1144565284 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1144565284",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GUMULAUSKAS",
    "FirstName": "LEEANN",
    "MiddleName": "ROCHELLE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SMITH",
    "OtherFirstName": "LEEANN",
    "OtherMiddleName": "ROCHELLE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1093 TAMARA DR SE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DARIEN",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "31305-4257",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "715-379-3101",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "501 GLOUCESTER ST STE 117",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BRUNSWICK",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "31520-7030",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "912-244-9919",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "11/29/2012",
    "LastUpdateDate": "10/18/2024",
    "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": "0701008515",
          "LicenseNumberStateCode": "VA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "4949-125",
          "LicenseNumberStateCode": "WI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "LPC013249",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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