{
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"OrgName": "SUSAN CONSOLI",
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"FirstName": null,
"MiddleName": null,
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"FirstLineMailingAddress": "823 BOSTON POST RD",
"SecondLineMailingAddress": "SUITE 4",
"MailingAddressCityName": "OLD SAYBROOK",
"MailingAddressStateName": "CT",
"MailingAddressPostalCode": "06475-2100",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "823 BOSTON POST RD",
"SecondLinePracticeLocationAddress": "SUITE 4",
"PracticeLocationAddressCityName": "OLD SAYBROOK",
"PracticeLocationAddressStateName": "CT",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "860-575-8810",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/05/2011",
"LastUpdateDate": "06/05/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CONSOLI",
"AuthorizedOfficialFirstName": "SUSAN",
"AuthorizedOfficialMiddleName": "E.",
"AuthorizedOfficialTitle": "OWNER",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MA, LPC",
"AuthorizedOfficialTelephoneNumber": "860-575-8810",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Professional Counselor",
"LicenseNumber": "002036",
"LicenseNumberStateCode": "CT",
"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."
}
}
}
}