{
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"FirstLineMailingAddress": "518 28 RD",
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"MailingAddressStateName": "CO",
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"FirstLinePracticeLocationAddress": "518 28 RD",
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"EnumerationDate": "04/30/2017",
"LastUpdateDate": "04/30/2017",
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RUSY",
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"AuthorizedOfficialCredential": "LPC, RD",
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"Taxonomies": {
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"TaxonomyName": "Professional Counselor",
"LicenseNumber": "LPC 0013044",
"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}