{
"Npi": {
"NPI": "1184311730",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BRANDI TITSWORTH LPC, 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": "1401 RANSOM RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MENA",
"MailingAddressStateName": "AR",
"MailingAddressPostalCode": "71953-4427",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "479-216-4619",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1142 HIGHWAY 71 S STE C",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MENA",
"PracticeLocationAddressStateName": "AR",
"PracticeLocationAddressPostalCode": "71953-8078",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "479-437-7967",
"PracticeLocationAddressFaxNumber": "479-385-0260",
"EnumerationDate": "04/21/2023",
"LastUpdateDate": "04/21/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TITSWORTH",
"AuthorizedOfficialFirstName": "BRANDI",
"AuthorizedOfficialMiddleName": "MICHELLE",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MISS",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LPC",
"AuthorizedOfficialTelephoneNumber": "479-216-4619",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM0801X",
"TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}