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1417126582 NPI number — CHILDREN'S EVALUATION &COUNSELING CENTER LLC

NPI Number: 1417126582
Health Care Provider/Practitioner: CHILDREN'S EVALUATION &COUNSELING CENTER LLC

Information about “1417126582” NPI (CHILDREN'S EVALUATION &COUNSELING CENTER LLC) exists in 1417126582 in HTML format HTML  |  1417126582 in plain Text format TXT  |  1417126582 in PDF (Portable Document Format) PDF  |  1417126582 in an XML format XML  formats.

NPI Number : 1417126582 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1417126582",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "CHILDREN'S EVALUATION &COUNSELING CENTER LLC",
    "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": "PO BOX 2346",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BENTON",
    "MailingAddressStateName": "AR",
    "MailingAddressPostalCode": "72018-2346",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "501-776-7708",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "212 W. SEVIER",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BENTON",
    "PracticeLocationAddressStateName": "AR",
    "PracticeLocationAddressPostalCode": "72015",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "501-776-7708",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/22/2008",
    "LastUpdateDate": "02/22/2008",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "CALLISON",
    "AuthorizedOfficialFirstName": "MARY",
    "AuthorizedOfficialMiddleName": "ANN",
    "AuthorizedOfficialTitle": "LICENSED INDEPENDENT PSYCHOLOGICAL",
    "AuthorizedOfficialNamePrefix": "MS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "LPE-I",
    "AuthorizedOfficialTelephoneNumber": "501-776-7708",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "251S00000X",
        "TaxonomyName": "Community/Behavioral Health Agency",
        "LicenseNumber": "92-05 LPE-I",
        "LicenseNumberStateCode": "AR",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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