{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "THE PALMS COUNSELING CENTER LLC",
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"NameSuffix": null,
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"FirstLineMailingAddress": "3945 TORRES CIR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WEST PALM BEACH",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33409-8120",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "407-979-0555",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "9002 N MERIDIAN ST STE 200",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "INDIANAPOLIS",
"PracticeLocationAddressStateName": "IN",
"PracticeLocationAddressPostalCode": "46260-5350",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "317-629-8957",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/12/2018",
"LastUpdateDate": "04/12/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NEIDLINGER",
"AuthorizedOfficialFirstName": "JESSICA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LMHC",
"AuthorizedOfficialTelephoneNumber": "407-970-0555",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "101Y00000X",
"TaxonomyName": "Counselor",
"LicenseNumber": "39003194A",
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}