{
"Npi": {
"NPI": "1376934117",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MARY C. RAY",
"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": "400 PRINCE ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ALEXANDRIA",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "22314-3114",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "703-683-0920",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "201B S ROYAL ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ALEXANDRIA",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "22314-3329",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "703-683-0920",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/16/2015",
"LastUpdateDate": "02/16/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RAY",
"AuthorizedOfficialFirstName": "MARY",
"AuthorizedOfficialMiddleName": "CATHERINE",
"AuthorizedOfficialTitle": "SOLE PROPRIETOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LCSW,ACSW, SEP",
"AuthorizedOfficialTelephoneNumber": "703-683-0920",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": "0904001621",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}