{
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"OrgName": "CARDINAL PSYCHOLOGICAL SERVICES, L.L.C.",
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"FirstLineMailingAddress": "500 BLAND ST",
"SecondLineMailingAddress": "BLUEFIELD ARTS BUILDING",
"MailingAddressCityName": "BLUEFIELD",
"MailingAddressStateName": "WV",
"MailingAddressPostalCode": "24701",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "304-323-3511",
"MailingAddressFaxNumber": "304-324-0827",
"FirstLinePracticeLocationAddress": "500 BLAND ST",
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"PracticeLocationAddressTelephoneNumber": "304-323-3511",
"PracticeLocationAddressFaxNumber": "304-324-0827",
"EnumerationDate": "12/11/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "STEWARD",
"AuthorizedOfficialFirstName": "LEONARD",
"AuthorizedOfficialMiddleName": "ANDREW",
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"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": "PH.D.",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Psychologist",
"LicenseNumber": "193",
"LicenseNumberStateCode": "WV",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}