NPI Code Detail JSON Logo

1386285161 NPI number — ELIZABETH LOGAN TEDDER LPC

NPI Number: 1386285161
Health Care Provider/Practitioner: ELIZABETH LOGAN TEDDER LPC

Information about “1386285161” NPI (ELIZABETH LOGAN TEDDER LPC) exists in 1386285161 in HTML format HTML  |  1386285161 in plain Text format TXT  |  1386285161 in PDF (Portable Document Format) PDF  |  1386285161 in an XML format XML  formats.

NPI Number : 1386285161 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1386285161",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "TEDDER",
    "FirstName": "ELIZABETH",
    "MiddleName": "LOGAN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LPC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "TEDDER",
    "OtherFirstName": "LOGAN",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "LPC",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "1609 MOCKINGBIRD COURT, ST, B",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FLORENCE",
    "MailingAddressStateName": "AL",
    "MailingAddressPostalCode": "35630-7511",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "256-320-7781",
    "MailingAddressFaxNumber": "256-320-7776",
    "FirstLinePracticeLocationAddress": "1609 MOCKINGBIRD COURT, ST, B",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FLORENCE",
    "PracticeLocationAddressStateName": "AL",
    "PracticeLocationAddressPostalCode": "35630-7511",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "256-320-7781",
    "PracticeLocationAddressFaxNumber": "256-320-7776",
    "EnumerationDate": "10/03/2019",
    "LastUpdateDate": "10/28/2025",
    "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": "4120",
        "LicenseNumberStateCode": "AL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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