{
"Npi": {
"NPI": "1346968773",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MUMFORD",
"FirstName": "NEIKYA",
"MiddleName": "KAMARA",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "MSW, LCSWA",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "SLADE",
"OtherFirstName": "NEIKYA",
"OtherMiddleName": "KAMARA",
"OtherNamePrefix": "MS.",
"OtherNameSuffix": null,
"OtherCredential": "MSW, LCSWA",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "PO BOX 39208",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GREENSBORO",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "27438-9208",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3606 MIZELL RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GREENSBORO",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "27405-2612",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "336-324-1427",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/22/2022",
"LastUpdateDate": "08/22/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "101YM0800X",
"TaxonomyName": "Mental Health Counselor",
"LicenseNumber": "P016279",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}