NPI Code Detail JSON Logo

1245484260 NPI number — TRACIE MCCOY EDMONDS LPC

NPI Number: 1245484260
Health Care Provider/Practitioner: TRACIE MCCOY EDMONDS LPC

Information about “1245484260” NPI (TRACIE MCCOY EDMONDS LPC) exists in 1245484260 in HTML format HTML  |  1245484260 in plain Text format TXT  |  1245484260 in PDF (Portable Document Format) PDF  |  1245484260 in an XML format XML  formats.

NPI Number : 1245484260 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1245484260",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "EDMONDS",
    "FirstName": "TRACIE",
    "MiddleName": "MCCOY",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LPC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3909 BIRDBROOK DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "COLONIAL HEIGHTS",
    "MailingAddressStateName": "VA",
    "MailingAddressPostalCode": "23834-1691",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "804-520-0153",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "5024 BRYANBELL LN",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "RICHMOND",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "23234-8004",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "804-279-8995",
    "PracticeLocationAddressFaxNumber": "804-279-8996",
    "EnumerationDate": "11/05/2008",
    "LastUpdateDate": "11/05/2008",
    "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": "101YP2500X",
        "TaxonomyName": "Professional Counselor",
        "LicenseNumber": "0701003763",
        "LicenseNumberStateCode": "VA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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