{
"Npi": {
"NPI": "1437077567",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "YOUNG",
"FirstName": "MARY",
"MiddleName": "SEITZ",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "LPCA",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "SPRATLIN",
"OtherFirstName": "MARY",
"OtherMiddleName": "SEITZ",
"OtherNamePrefix": "MRS.",
"OtherNameSuffix": null,
"OtherCredential": "LPCA",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "3812 W MONTAGUE AVE APT 1308",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NORTH CHARLESTON",
"MailingAddressStateName": "SC",
"MailingAddressPostalCode": "29418-6107",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "601-717-2914",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3 OAK FOREST DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CHARLESTON",
"PracticeLocationAddressStateName": "SC",
"PracticeLocationAddressPostalCode": "29407-7078",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "843-410-9046",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/07/2026",
"LastUpdateDate": "07/07/2026",
"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": "101YM0800X",
"TaxonomyName": "Mental Health Counselor",
"LicenseNumber": "11098",
"LicenseNumberStateCode": "SC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}