{
"Npi": {
"NPI": "1184473597",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BUILDING INDIVIDUALS GRADUALLY COUNSELING SERVICES B.I.G LLC",
"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": "2807 N PARHAM RD STE 320",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HENRICO",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23294-4458",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "434-838-0705",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2807 N PARHAM RD STE 320",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HENRICO",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "23294-4458",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "434-838-0705",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/16/2024",
"LastUpdateDate": "05/16/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KERSHAW",
"AuthorizedOfficialFirstName": "MARITA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LCSW",
"AuthorizedOfficialTelephoneNumber": "914-563-8873",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM0850X",
"TaxonomyName": "Adult Mental Health Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}