{
"Npi": {
"NPI": "1316289531",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JONATHAN STERN, M.S., L.P.C., L.A.D.C., COUNSELING AND PSYCHOTHERAPY S",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2911 DIXWELL AVE",
"SecondLineMailingAddress": "SUITE B-5",
"MailingAddressCityName": "HAMDEN",
"MailingAddressStateName": "CT",
"MailingAddressPostalCode": "06518-3195",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "203-916-5496",
"MailingAddressFaxNumber": "203-265-1216",
"FirstLinePracticeLocationAddress": "2911 DIXWELL AVE",
"SecondLinePracticeLocationAddress": "SUITE B-5",
"PracticeLocationAddressCityName": "HAMDEN",
"PracticeLocationAddressStateName": "CT",
"PracticeLocationAddressPostalCode": "06518-3195",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "203-916-5496",
"PracticeLocationAddressFaxNumber": "203-265-1216",
"EnumerationDate": "03/26/2013",
"LastUpdateDate": "03/26/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "STERN",
"AuthorizedOfficialFirstName": "JONATHAN",
"AuthorizedOfficialMiddleName": "DAVID",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "L.P.C., L.A.D.C.",
"AuthorizedOfficialTelephoneNumber": "203-213-9987",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": "000823",
"LicenseNumberStateCode": "CT",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": "001882",
"LicenseNumberStateCode": "CT",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}