1306240130 NPI number — KARIMAH ROSE LMFT-S, LPC-S

NPI Number: 1306240130
Health Care Provider/Practitioner: KARIMAH ROSE LMFT-S, LPC-S

NPI Number : 1306240130 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1306240130",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ROSE",
    "FirstName": "KARIMAH",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LMFT-S, LPC-S",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "9002 HIGHLANDS CV",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BOERNE",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "78006-4843",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "254-466-3622",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2631 GATTIS SCHOOL RD STE 135",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ROUND ROCK",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "78664-2828",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "512-298-1324",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/22/2014",
    "LastUpdateDate": "08/30/2023",
    "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": "73205",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "106H00000X",
          "TaxonomyName": "Marriage & Family Therapist",
          "LicenseNumber": "202254",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}