1285124487 NPI number — MONIQUE MARIE GILCREST M.S., LPC-I

NPI Number: 1285124487
Health Care Provider/Practitioner: MONIQUE MARIE GILCREST M.S., LPC-I

NPI Number : 1285124487 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1285124487",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GILCREST",
    "FirstName": "MONIQUE",
    "MiddleName": "MARIE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "M.S., LPC-I",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "GILCREST",
    "OtherFirstName": "NIKKI",
    "OtherMiddleName": null,
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "M.S., LPC-I",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "1205 BRYTON TRCE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "COLUMBIA",
    "MailingAddressStateName": "SC",
    "MailingAddressPostalCode": "29210-3642",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "803-238-8681",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1205 BRYTON TRCE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "COLUMBIA",
    "PracticeLocationAddressStateName": "SC",
    "PracticeLocationAddressPostalCode": "29210-3642",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "803-238-8681",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/14/2018",
    "LastUpdateDate": "05/14/2018",
    "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": "6587",
        "LicenseNumberStateCode": "SC",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}