1285857490 NPI number — ELINOR PHILLIPS DICKSHINSKI M.S., NCC, L.C.P.C

NPI Number: 1285857490
Health Care Provider/Practitioner: ELINOR PHILLIPS DICKSHINSKI M.S., NCC, L.C.P.C

NPI Number : 1285857490 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1285857490",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DICKSHINSKI",
    "FirstName": "ELINOR",
    "MiddleName": "PHILLIPS",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "M.S., NCC, L.C.P.C",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "8834 COTTONGRASS ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WALDORF",
    "MailingAddressStateName": "MD",
    "MailingAddressPostalCode": "20603-4943",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "240-441-8095",
    "MailingAddressFaxNumber": "301-710-0175",
    "FirstLinePracticeLocationAddress": "28105 THREE NOTCH RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MECHANICSVILLE",
    "PracticeLocationAddressStateName": "MD",
    "PracticeLocationAddressPostalCode": "20659-3235",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "240-441-8095",
    "PracticeLocationAddressFaxNumber": "301-710-0175",
    "EnumerationDate": "04/10/2007",
    "LastUpdateDate": "03/10/2015",
    "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": "LC3400",
        "LicenseNumberStateCode": "MD",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}