{
"Npi": {
"NPI": "1306328927",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "PICKENS",
"FirstName": "JACLYN",
"MiddleName": "DANIELLE CRAVENS",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "LMFT-A",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "CRAVENS",
"OtherFirstName": "JACLYN",
"OtherMiddleName": "DANIELLE",
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "LMFTA",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "8212 ITHACA AVE STE E12",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LUBBOCK",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "79423-2615",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "252-702-9277",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "8212 ITHACA AVE STE E12",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LUBBOCK",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "79423-2615",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "252-702-9277",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/30/2018",
"LastUpdateDate": "08/30/2018",
"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": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "202702",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}