{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "WOHL'S COUNSELING CLINIC,LLC",
"LastName": null,
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"NameSuffix": null,
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"FirstLineMailingAddress": "400 E CENTRAL AVE",
"SecondLineMailingAddress": "STE.303E",
"MailingAddressCityName": "PONCA CITY",
"MailingAddressStateName": "OK",
"MailingAddressPostalCode": "74601-5429",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "580-762-6511",
"MailingAddressFaxNumber": "580-762-6511",
"FirstLinePracticeLocationAddress": "400 E CENTRAL AVE",
"SecondLinePracticeLocationAddress": "STE.303E",
"PracticeLocationAddressCityName": "PONCA CITY",
"PracticeLocationAddressStateName": "OK",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "580-762-6511",
"PracticeLocationAddressFaxNumber": "580-762-6511",
"EnumerationDate": "06/29/2010",
"LastUpdateDate": "06/29/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WOHL",
"AuthorizedOfficialFirstName": "SAMANTHA",
"AuthorizedOfficialMiddleName": "JO",
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"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LPC",
"AuthorizedOfficialTelephoneNumber": "580-762-6511",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "101YM0800X",
"TaxonomyName": "Mental Health Counselor",
"LicenseNumber": "3745",
"LicenseNumberStateCode": "OK",
"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."
}
}
}
}