{
"Npi": {
"NPI": "1457866105",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SIMPLICITY COUNSELING SERVICES PLLC",
"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": "662 N SPENCE AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GOLDSBORO",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "27534-4233",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "919-988-6620",
"MailingAddressFaxNumber": "919-788-0827",
"FirstLinePracticeLocationAddress": "696 N SPENCE AVE STE A",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GOLDSBORO",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "27534-4354",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "919-330-4147",
"PracticeLocationAddressFaxNumber": "193-304-1429",
"EnumerationDate": "12/04/2017",
"LastUpdateDate": "02/13/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HOLDCROFT",
"AuthorizedOfficialFirstName": "CRYSTAL",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "770-527-7966",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "C008406",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "101YA0400X",
"TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
"LicenseNumber": "3391-A",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "101YM0800X",
"TaxonomyName": "Mental Health Counselor",
"LicenseNumber": "A11401",
"LicenseNumberStateCode": "NC",
"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."
}
]
}
}
}