{
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"NPI": "1306972583",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "ELLEN R ZALDO, MS, LPC, PC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherOrgNameTypeCode": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3419 VIRGINIA BEACH BLVD",
"SecondLineMailingAddress": "BOX 157",
"MailingAddressCityName": "VIRGINIA BEACH",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23452-4419",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "757-631-5348",
"MailingAddressFaxNumber": "757-321-6269",
"FirstLinePracticeLocationAddress": "933 FIRST COLONIAL RD",
"SecondLinePracticeLocationAddress": "SUITE 202",
"PracticeLocationAddressCityName": "VIRGINIA BEACH",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "23454-3172",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "757-631-5348",
"PracticeLocationAddressFaxNumber": "757-321-6269",
"EnumerationDate": "02/24/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ZALDO",
"AuthorizedOfficialFirstName": "ELLEN",
"AuthorizedOfficialMiddleName": "R",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LPC",
"AuthorizedOfficialTelephoneNumber": "757-631-5348",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "101YP2500X",
"TaxonomyName": "Professional Counselor",
"LicenseNumber": "0701001685",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}