{
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"EIN": null,
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"LastName": "PHILLIPS",
"FirstName": "BONNIE",
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"Credential": "MFT",
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1909 BEARBERRY LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ASHEVILLE",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "28803-3241",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "714-624-0399",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1550 HENDERSONVILLE RD STE 202",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ASHEVILLE",
"PracticeLocationAddressStateName": "NC",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "828-351-4172",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/22/2007",
"LastUpdateDate": "01/29/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "46460",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "2532",
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"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}