NPI Code Detail JSON Logo

1316696149 NPI number — PSYCHSOMATICA PLLC

NPI Number: 1316696149
Health Care Provider/Practitioner: PSYCHSOMATICA PLLC

Information about “1316696149” NPI (PSYCHSOMATICA PLLC) exists in 1316696149 in HTML format HTML  |  1316696149 in plain Text format TXT  |  1316696149 in PDF (Portable Document Format) PDF  |  1316696149 in an XML format XML  formats.

NPI Number : 1316696149 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1316696149",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PSYCHSOMATICA PLLC",
    "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": "6107 N GLENWOOD AVE APT 3",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CHICAGO",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60660-1894",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "615-347-5656",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "6107 N GLENWOOD AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CHICAGO",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60660-1894",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "615-347-5656",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/20/2022",
    "LastUpdateDate": "08/01/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "ENGLAND",
    "AuthorizedOfficialFirstName": "HOPE",
    "AuthorizedOfficialMiddleName": "MARIE",
    "AuthorizedOfficialTitle": "CEO",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "LCPC",
    "AuthorizedOfficialTelephoneNumber": "615-347-5656",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "261QM0850X",
        "TaxonomyName": "Adult Mental Health Clinic/Center",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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