1295386464 NPI number — CARRIE DAWN GEORGE BS, MSCJ, MAC, LPC

NPI Number: 1295386464
Health Care Provider/Practitioner: CARRIE DAWN GEORGE BS, MSCJ, MAC, LPC

NPI Number : 1295386464 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1295386464",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GEORGE",
    "FirstName": "CARRIE",
    "MiddleName": "DAWN",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "BS, MSCJ, MAC, LPC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "4812 BRIXSTON DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HILLIARD",
    "MailingAddressStateName": "OH",
    "MailingAddressPostalCode": "43026-8522",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "380-235-9078",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "4653 E MAIN ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WHITEHALL",
    "PracticeLocationAddressStateName": "OH",
    "PracticeLocationAddressPostalCode": "43213-3298",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "380-235-9078",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/27/2019",
    "LastUpdateDate": "01/08/2024",
    "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": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "C.2405724",
          "LicenseNumberStateCode": "OH",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "C.2405724",
          "LicenseNumberStateCode": "OH",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101Y00000X",
          "TaxonomyName": "Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}