{
"Npi": {
"NPI": "1437514908",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "ORTEZ",
"FirstName": "HERMAN",
"MiddleName": null,
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "EDD, LPCMH, NCC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "ORTEZ",
"OtherFirstName": "HERMAN",
"OtherMiddleName": null,
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "LPCMH, NCC",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "308 BAYARD ST STE 655",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DELAWARE CITY",
"MailingAddressStateName": "DE",
"MailingAddressPostalCode": "19706-8728",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "302-559-3475",
"MailingAddressFaxNumber": "302-838-2969",
"FirstLinePracticeLocationAddress": "3301 GREEN ST STE 241",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CLAYMONT",
"PracticeLocationAddressStateName": "DE",
"PracticeLocationAddressPostalCode": "19703-2052",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "302-559-4683",
"PracticeLocationAddressFaxNumber": "302-838-2969",
"EnumerationDate": "12/28/2015",
"LastUpdateDate": "06/22/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"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": "PC-0000891",
"LicenseNumberStateCode": "DE",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "101YA0400X",
"TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
"LicenseNumber": "PC-0000891",
"LicenseNumberStateCode": "DE",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "101YP2500X",
"TaxonomyName": "Professional Counselor",
"LicenseNumber": "PC-0000891",
"LicenseNumberStateCode": "DE",
"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."
},
{
"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."
},
{
"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."
}
]
}
}
}