{
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "INSIGHTFUL COUNSELING SERVICES, INC",
"ParentOrgTIN": null,
"OrgName": "INSIGHTFUL COUNSELING SERVICES, INC.",
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"NamePrefix": null,
"NameSuffix": null,
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"FirstLineMailingAddress": "1103 SW 2ND AVE",
"SecondLineMailingAddress": "CEDAR HEALTHCARE",
"MailingAddressCityName": "GAINESVILLE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32601",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "352-378-9116",
"MailingAddressFaxNumber": "352-378-9779",
"FirstLinePracticeLocationAddress": "1103 SW 2ND AVE.",
"SecondLinePracticeLocationAddress": "CEDAR HEALTHCARE",
"PracticeLocationAddressCityName": "GAINESVILLE",
"PracticeLocationAddressStateName": "FL",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "352-378-9116",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/29/2012",
"LastUpdateDate": "06/29/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KERSEY M.S. LMHC",
"AuthorizedOfficialFirstName": "TALANA",
"AuthorizedOfficialMiddleName": "SIEVERT",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.S. LMHC",
"AuthorizedOfficialTelephoneNumber": "352-591-4348",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "101YM0800X",
"TaxonomyName": "Mental Health Counselor",
"LicenseNumber": "MH5742",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}