{
"Npi": {
"NPI": "1184312704",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "WORKING WELLNESS SOLUTIONS L.L.C.",
"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": "30957 LORRAINE AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WARREN",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48093-8014",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "313-926-1683",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "11443 E 13 MILE RD STE 401",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WARREN",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "48093-6523",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "313-335-7435",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/01/2023",
"LastUpdateDate": "05/01/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MODEST",
"AuthorizedOfficialFirstName": "LAVITA",
"AuthorizedOfficialMiddleName": "SOPHIA",
"AuthorizedOfficialTitle": "BUSINESS OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LPC",
"AuthorizedOfficialTelephoneNumber": "313-926-1683",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "101YM0800X",
"TaxonomyName": "Mental Health Counselor",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"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."
}
}
}
}