1184941114 NPI number — MARY WRIGHT WILLIAMS L.P.C., L.M.F.T.

NPI Number: 1184941114
Health Care Provider/Practitioner: MARY WRIGHT WILLIAMS L.P.C., L.M.F.T.

NPI Number : 1184941114 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1184941114",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WILLIAMS",
    "FirstName": "MARY",
    "MiddleName": "WRIGHT",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "L.P.C., L.M.F.T.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MONTAGUE",
    "OtherFirstName": "MARY",
    "OtherMiddleName": "WILLIAMS",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "PO BOX 695",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GLOUCESTER",
    "MailingAddressStateName": "VA",
    "MailingAddressPostalCode": "23061-0695",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "804-832-1953",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "444 WATER LN",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "TAPPAHANNOCK",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "22560-5090",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "804-832-1953",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/30/2010",
    "LastUpdateDate": "04/30/2010",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "0701002720",
          "LicenseNumberStateCode": "VA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "106H00000X",
          "TaxonomyName": "Marriage & Family Therapist",
          "LicenseNumber": "0717000645",
          "LicenseNumberStateCode": "VA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}