{
"Npi": {
"NPI": "1295228344",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JULIE ODONNELL PHD LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 8575",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAINT JOSEPH",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "64508-8575",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "816-248-8929",
"MailingAddressFaxNumber": "816-873-1220",
"FirstLinePracticeLocationAddress": "708 S WOODBINE RD STE A",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAINT JOSEPH",
"PracticeLocationAddressStateName": "MO",
"PracticeLocationAddressPostalCode": "64507",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "816-248-8929",
"PracticeLocationAddressFaxNumber": "816-873-1220",
"EnumerationDate": "06/13/2018",
"LastUpdateDate": "07/13/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ODONNELL",
"AuthorizedOfficialFirstName": "JULIE",
"AuthorizedOfficialMiddleName": "ANN",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHD",
"AuthorizedOfficialTelephoneNumber": "785-288-8172",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM0801X",
"TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
"LicenseNumber": "2018012574",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}