{
"Npi": {
"NPI": "1225377047",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "AMITY CIRCLE COUNSELING SERVICES",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "6797 N HIGH ST",
"SecondLineMailingAddress": "#155",
"MailingAddressCityName": "WORTHINGTON",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "43085-2533",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "614-886-1238",
"MailingAddressFaxNumber": "740-524-2010",
"FirstLinePracticeLocationAddress": "6797 N HIGH ST",
"SecondLinePracticeLocationAddress": "#155",
"PracticeLocationAddressCityName": "WORTHINGTON",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "43085-2533",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "614-886-1238",
"PracticeLocationAddressFaxNumber": "740-524-2010",
"EnumerationDate": "02/14/2013",
"LastUpdateDate": "02/14/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MCLYMONT-MITCHELL",
"AuthorizedOfficialFirstName": "TANYA",
"AuthorizedOfficialMiddleName": "MAY",
"AuthorizedOfficialTitle": "THERAPIST/OWNER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LPCC",
"AuthorizedOfficialTelephoneNumber": "614-886-1238",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "101YP2500X",
"TaxonomyName": "Professional Counselor",
"LicenseNumber": "E0600702",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
}
}
}
}