{
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"ParentOrgLBN": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "119 PERE MARQUETTE DR STE 3B",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LANSING",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48912-1270",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "517-855-0597",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "119 PERE MARQUETTE DR STE 3B",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LANSING",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "517-855-0597",
"PracticeLocationAddressFaxNumber": "517-455-7560",
"EnumerationDate": "12/06/2017",
"LastUpdateDate": "11/03/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ALLSWEDE",
"AuthorizedOfficialFirstName": "LAUREN",
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"AuthorizedOfficialTitle": "OWNER",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LMSW",
"AuthorizedOfficialTelephoneNumber": "517-455-7555",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": "6801091060",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}