{
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"FirstLineMailingAddress": "46036 MICHIGAN AVENUE",
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"MailingAddressCityName": "CANTON",
"MailingAddressStateName": "MI",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2081 W WILLIAMS CIR",
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"PracticeLocationAddressCityName": "WESTLAND",
"PracticeLocationAddressStateName": "MI",
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"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/06/2020",
"LastUpdateDate": "01/18/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CRAWFORD",
"AuthorizedOfficialFirstName": "MONICA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LPC",
"AuthorizedOfficialTelephoneNumber": "734-606-9326",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Counselor",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
}
}
}
}