{
"Npi": {
"NPI": "1366346835",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SELAH PSYCHIATRIC CARE & WELLNESS, LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "605 N BROAD STREET SUITE 5",
"SecondLineMailingAddress": "369",
"MailingAddressCityName": "MIDDLETOWN",
"MailingAddressStateName": "DE",
"MailingAddressPostalCode": "19709-1052",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "302-303-5276",
"MailingAddressFaxNumber": "302-208-8934",
"FirstLinePracticeLocationAddress": "605 N BROAD ST STE 5",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MIDDLETOWN",
"PracticeLocationAddressStateName": "DE",
"PracticeLocationAddressPostalCode": "19709-1052",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "302-303-5276",
"PracticeLocationAddressFaxNumber": "302-208-8934",
"EnumerationDate": "10/07/2026",
"LastUpdateDate": "10/07/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HAWKINS",
"AuthorizedOfficialFirstName": "CHRYSTAL",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PMHNP",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "NP",
"AuthorizedOfficialTelephoneNumber": "302-303-5276",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "363LP0808X",
"TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
"LicenseNumber": null,
"LicenseNumberStateCode": "NULL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}