{
"Npi": {
"NPI": "1396147666",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NIO PSYCHOLOGICAL SERVICES, PLLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "602 E ACADEMY ST STE 104",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FUQUAY VARINA",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "27526-2382",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "10-285-1221",
"MailingAddressFaxNumber": "919-346-0449",
"FirstLinePracticeLocationAddress": "602 E ACADEMY ST STE 104",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FUQUAY VARINA",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "27526-2382",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "919-285-1221",
"PracticeLocationAddressFaxNumber": "919-346-0449",
"EnumerationDate": "09/18/2014",
"LastUpdateDate": "11/21/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BAPTISTA DE PAPARELLA",
"AuthorizedOfficialFirstName": "NIOSOTY",
"AuthorizedOfficialMiddleName": "MARGARITA",
"AuthorizedOfficialTitle": "PSYCHOLOGIST/OWNER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MA, LPA",
"AuthorizedOfficialTelephoneNumber": "919-274-5618",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "103T00000X",
"TaxonomyName": "Psychologist",
"LicenseNumber": "4014",
"LicenseNumberStateCode": "NC",
"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."
}
}
}
}