{
"Npi": {
"NPI": "1306554969",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BURNSIDE",
"FirstName": "BONNIE",
"MiddleName": "ELIZABETH",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "LCDC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "WARDEN",
"OtherFirstName": "BONNIE",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "3429 SHEFFIELD CIR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PLANO",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75075-3437",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3330 S LANCASTER RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DALLAS",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75216-4531",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "214-371-0474",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/11/2022",
"LastUpdateDate": "11/10/2025",
"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": "225C00000X",
"TaxonomyName": "Rehabilitation Counselor",
"LicenseNumber": "10924",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}