{
"Npi": {
"NPI": "1235500547",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "THE BINDU INSTITUTE, 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": "1913 HIGHWAY 87",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NAVARRE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32566-1017",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "850-816-8122",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1913 HIGHWAY 87",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NAVARRE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32566-1017",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "850-692-9824",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/13/2015",
"LastUpdateDate": "11/29/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ELLIS",
"AuthorizedOfficialFirstName": "TRINITY",
"AuthorizedOfficialMiddleName": "NOEL",
"AuthorizedOfficialTitle": "CEO LICENSED MENTAL HEALTH COUNSELO",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "850-816-8122",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "101YM0800X",
"TaxonomyName": "Mental Health Counselor",
"LicenseNumber": "MH 10297",
"LicenseNumberStateCode": "FL",
"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."
}
}
}
}