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1154427631 NPI number — VON F. BORG LPCC, LADC

NPI Number: 1154427631
Health Care Provider/Practitioner: VON F. BORG LPCC, LADC

Information about “1154427631” NPI (VON F. BORG LPCC, LADC) exists in 1154427631 in HTML format HTML  |  1154427631 in plain Text format TXT  |  1154427631 in PDF (Portable Document Format) PDF  |  1154427631 in an XML format XML  formats.

NPI Number : 1154427631 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1154427631",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BORG",
    "FirstName": "VON",
    "MiddleName": "F.",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "LPCC, LADC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 302",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BEAVER BAY",
    "MailingAddressStateName": "MN",
    "MailingAddressPostalCode": "55601-0302",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "YOKOTA AIR BASE",
    "SecondLinePracticeLocationAddress": "UNIT 5071",
    "PracticeLocationAddressCityName": "APO",
    "PracticeLocationAddressStateName": "AP",
    "PracticeLocationAddressPostalCode": "96328",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "315-225-8391",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/15/2006",
    "LastUpdateDate": "06/14/2018",
    "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": "101YA0400X",
          "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
          "LicenseNumber": "257",
          "LicenseNumberStateCode": "OK",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YA0400X",
          "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
          "LicenseNumber": "304451",
          "LicenseNumberStateCode": "MN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "1446",
          "LicenseNumberStateCode": "OK",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "CC00184",
          "LicenseNumberStateCode": "MN",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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