{
"Npi": {
"NPI": "1346876661",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FIND YOUR BALANCE PSYCHOTHERAPY, LLC",
"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": "1920 MATOAX AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PETERSBURG",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23805-2843",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "804-835-5853",
"MailingAddressFaxNumber": "804-251-1342",
"FirstLinePracticeLocationAddress": "7410 HULL STREET RD STE 102",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NORTH CHESTERFIELD",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "23235-5834",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "804-835-5853",
"PracticeLocationAddressFaxNumber": "804-251-1342",
"EnumerationDate": "03/18/2020",
"LastUpdateDate": "08/25/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MOTLEY MOORE",
"AuthorizedOfficialFirstName": "MELISSA",
"AuthorizedOfficialMiddleName": "OLIVIA",
"AuthorizedOfficialTitle": "THERAPIST",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LPC",
"AuthorizedOfficialTelephoneNumber": "804-835-5853",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}