1356708218 NPI number — DANA KRISTINE PHILLIPS LPC, NCC, SAC,MA

NPI Number: 1356708218
Health Care Provider/Practitioner: DANA KRISTINE PHILLIPS LPC, NCC, SAC,MA

NPI Number : 1356708218 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1356708218",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PHILLIPS",
    "FirstName": "DANA",
    "MiddleName": "KRISTINE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "LPC, NCC, SAC,MA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "LOGANDRO",
    "OtherFirstName": "DANA",
    "OtherMiddleName": "KRISTINE",
    "OtherNamePrefix": "MISS",
    "OtherNameSuffix": null,
    "OtherCredential": "LPC, NCC, SAC,MA",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "630 CLEMENTS BRIDGE RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BARRINGTON",
    "MailingAddressStateName": "NJ",
    "MailingAddressPostalCode": "08007-1814",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "856-617-4267",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "630 CLEMENTS BRIDGE RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BARRINGTON",
    "PracticeLocationAddressStateName": "NJ",
    "PracticeLocationAddressPostalCode": "08007-1814",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "856-617-4267",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/24/2016",
    "LastUpdateDate": "07/06/2023",
    "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": "101YP2500X",
        "TaxonomyName": "Professional Counselor",
        "LicenseNumber": "37PC00477200",
        "LicenseNumberStateCode": "NJ",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}