{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "RKO PSYCHOTHERAPY, P.A.",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherOrgNameTypeCode": "6",
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"OtherCredential": null,
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"FirstLineMailingAddress": "205 E US HIGHWAY 80",
"SecondLineMailingAddress": "SUITE 110",
"MailingAddressCityName": "FORNEY",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75126-8604",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "214-458-0646",
"MailingAddressFaxNumber": "972-552-2233",
"FirstLinePracticeLocationAddress": "205 E US HIGHWAY 80",
"SecondLinePracticeLocationAddress": "SUITE 110",
"PracticeLocationAddressCityName": "FORNEY",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75126-8604",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "214-458-0646",
"PracticeLocationAddressFaxNumber": "972-552-2233",
"EnumerationDate": "04/03/2017",
"LastUpdateDate": "04/03/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "OWEN",
"AuthorizedOfficialFirstName": "RICKY",
"AuthorizedOfficialMiddleName": "BRENT",
"AuthorizedOfficialTitle": "SENIOR THERAPIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHD, LMFT",
"AuthorizedOfficialTelephoneNumber": "214-458-0646",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"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."
}
}
}
}