{
"Npi": {
"NPI": "1184052227",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BOWEN GROUP FOUNDATION",
"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": "1157 WHITNEY LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WESTERVILLE",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "43081-3688",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "614-899-0075",
"MailingAddressFaxNumber": "614-899-0075",
"FirstLinePracticeLocationAddress": "1890 NORTHWEST BLVD",
"SecondLinePracticeLocationAddress": "SUITE 140",
"PracticeLocationAddressCityName": "COLUMBUS",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "43212-1637",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "614-899-0075",
"PracticeLocationAddressFaxNumber": "614-899-0075",
"EnumerationDate": "10/29/2013",
"LastUpdateDate": "10/29/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BOWEN",
"AuthorizedOfficialFirstName": "NIKOL",
"AuthorizedOfficialMiddleName": "V",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHD, PCC",
"AuthorizedOfficialTelephoneNumber": "614-899-0075",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": "E0700105",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}