1295996270 NPI number — LISA DUKE CARY LPC, CEAP, CRC, CRP

NPI Number: 1295996270
Health Care Provider/Practitioner: LISA DUKE CARY LPC, CEAP, CRC, CRP

NPI Number : 1295996270 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1295996270",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CARY",
    "FirstName": "LISA",
    "MiddleName": "DUKE",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "LPC, CEAP, CRC, CRP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1721 EBENEZER RD",
    "SecondLineMailingAddress": "SUITE 225",
    "MailingAddressCityName": "ROCK HILL",
    "MailingAddressStateName": "SC",
    "MailingAddressPostalCode": "29732-4103",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "803-329-9639",
    "MailingAddressFaxNumber": "803-329-5830",
    "FirstLinePracticeLocationAddress": "1721 EBENEZER RD",
    "SecondLinePracticeLocationAddress": "SUITE 225",
    "PracticeLocationAddressCityName": "ROCK HILL",
    "PracticeLocationAddressStateName": "SC",
    "PracticeLocationAddressPostalCode": "29732-4103",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "803-329-9639",
    "PracticeLocationAddressFaxNumber": "803-329-5830",
    "EnumerationDate": "06/22/2008",
    "LastUpdateDate": "03/05/2017",
    "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": "0701003959",
          "LicenseNumberStateCode": "VA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "6539",
          "LicenseNumberStateCode": "SC",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}