{
"Npi": {
"NPI": "1356406870",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "WEGMANN",
"FirstName": "MARY HELEN",
"MiddleName": "'NELL'",
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "MA, LMFT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "WEGMANN",
"OtherFirstName": "NELL",
"OtherMiddleName": "HELEN",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "MA, LMFT",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "505 LIBBIE AVE",
"SecondLineMailingAddress": "COUPLES COUNSELING LLC",
"MailingAddressCityName": "RICHMOND",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23226-2617",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "804-873-0338",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "505 LIBBIE AVE",
"SecondLinePracticeLocationAddress": "COUPLES COUNSELING LLC",
"PracticeLocationAddressCityName": "RICHMOND",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "23226-2617",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "804-873-0338",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/26/2006",
"LastUpdateDate": "06/22/2011",
"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": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "79-124",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "0717001201",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}