NPI Code Detail JSON Logo

1215769054 NPI number — LIFE WITH A CUP OF JO LLC

NPI Number: 1215769054
Health Care Provider/Practitioner: LIFE WITH A CUP OF JO LLC

Information about “1215769054” NPI (LIFE WITH A CUP OF JO LLC) exists in 1215769054 in HTML format HTML  |  1215769054 in plain Text format TXT  |  1215769054 in PDF (Portable Document Format) PDF  |  1215769054 in an XML format XML  formats.

NPI Number : 1215769054 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1215769054",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "LIFE WITH A CUP OF JO LLC",
    "ParentOrgTIN": null,
    "OrgName": "LIFE WITH A CUP OF JO 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": "386 WALMART DR STE 7",
    "SecondLineMailingAddress": "PMB 18",
    "MailingAddressCityName": "CAMDEN",
    "MailingAddressStateName": "DE",
    "MailingAddressPostalCode": "19934-1374",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "808-343-2829",
    "MailingAddressFaxNumber": "833-804-2660",
    "FirstLinePracticeLocationAddress": "39 NORTH WALNUT STREET",
    "SecondLinePracticeLocationAddress": "SUITE 108",
    "PracticeLocationAddressCityName": "MILFORD",
    "PracticeLocationAddressStateName": "DE",
    "PracticeLocationAddressPostalCode": "19963-1467",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "808-343-2829",
    "PracticeLocationAddressFaxNumber": "833-804-2660",
    "EnumerationDate": "08/19/2024",
    "LastUpdateDate": "04/16/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "CORDERO",
    "AuthorizedOfficialFirstName": "JOCELYN",
    "AuthorizedOfficialMiddleName": "G",
    "AuthorizedOfficialTitle": "PSYCHOTHERAPIST",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "LMFT",
    "AuthorizedOfficialTelephoneNumber": "808-343-2829",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "251S00000X",
          "TaxonomyName": "Community/Behavioral Health Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "106H00000X",
          "TaxonomyName": "Marriage & Family Therapist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.