{
"Npi": {
"NPI": "1457184699",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "JOHNSTON",
"FirstName": "JESSIE",
"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": "2409 ROCKY MOUNTAIN AVE UNIT 201",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LOVELAND",
"MailingAddressStateName": "CO",
"MailingAddressPostalCode": "80538-8931",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "518-307-5743",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "363 W DRAKE RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FORT COLLINS",
"PracticeLocationAddressStateName": "CO",
"PracticeLocationAddressPostalCode": "80526-6323",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "970-465-2977",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/22/2024",
"LastUpdateDate": "08/01/2025",
"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": "103T00000X",
"TaxonomyName": "Psychologist",
"LicenseNumber": "PSY.0006777",
"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "103T00000X",
"TaxonomyName": "Psychologist",
"LicenseNumber": "14114257-2501",
"LicenseNumberStateCode": "UT",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}