NPI Code Detail JSON Logo

1366829079 NPI number — CENTER FOR COUNSELING AND MINDFUL LIVING, LLC

NPI Number: 1366829079
Health Care Provider/Practitioner: CENTER FOR COUNSELING AND MINDFUL LIVING, LLC

Information about “1366829079” NPI (CENTER FOR COUNSELING AND MINDFUL LIVING, LLC) exists in 1366829079 in HTML format HTML  |  1366829079 in plain Text format TXT  |  1366829079 in PDF (Portable Document Format) PDF  |  1366829079 in an XML format XML  formats.

NPI Number : 1366829079 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1366829079",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "CENTER FOR COUNSELING AND MINDFUL LIVING, 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": "P.O. BOX 629",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PRINCETON",
    "MailingAddressStateName": "NJ",
    "MailingAddressPostalCode": "08542-0629",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "908-516-8422",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "257 US HIGHWAY 22",
    "SecondLinePracticeLocationAddress": "SUITE B",
    "PracticeLocationAddressCityName": "GREEN BROOK",
    "PracticeLocationAddressStateName": "NJ",
    "PracticeLocationAddressPostalCode": "08812-1807",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "908-516-8422",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/01/2015",
    "LastUpdateDate": "04/28/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "CHAFOS",
    "AuthorizedOfficialFirstName": "VANESSA",
    "AuthorizedOfficialMiddleName": "H.",
    "AuthorizedOfficialTitle": "FOUNDER",
    "AuthorizedOfficialNamePrefix": "MS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "PH.D.",
    "AuthorizedOfficialTelephoneNumber": "908-516-8422",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "37PC00515300",
          "LicenseNumberStateCode": "NJ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "103T00000X",
          "TaxonomyName": "Psychologist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "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."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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