{
"Npi": {
"NPI": "1225163884",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "RILEY",
"FirstName": "SARA",
"MiddleName": "E.",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "MSCP, LPC, NCC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 2552",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "VALDOSTA",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "31604-2552",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "229-563-6169",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2200 N PATTERSON ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "VALDOSTA",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "31602-2597",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "229-244-1707",
"PracticeLocationAddressFaxNumber": "299-244-1779",
"EnumerationDate": "02/23/2007",
"LastUpdateDate": "03/06/2009",
"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": "101Y00000X",
"TaxonomyName": "Counselor",
"LicenseNumber": "NCC223805",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "101YM0800X",
"TaxonomyName": "Mental Health Counselor",
"LicenseNumber": "LPC 004549",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "101YP2500X",
"TaxonomyName": "Professional Counselor",
"LicenseNumber": "LPC0004549",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}