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1477389716 NPI number — SOPHRON COUNSELING SERVICES, PLLC

NPI Number: 1477389716
Health Care Provider/Practitioner: SOPHRON COUNSELING SERVICES, PLLC

Information about “1477389716” NPI (SOPHRON COUNSELING SERVICES, PLLC) exists in 1477389716 in HTML format HTML  |  1477389716 in plain Text format TXT  |  1477389716 in PDF (Portable Document Format) PDF  |  1477389716 in an XML format XML  formats.

NPI Number : 1477389716 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1477389716",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "SOPHRON 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": "187 S INDIANA AVE STE 307",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "KANKAKEE",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60901-3645",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "815-408-1262",
    "MailingAddressFaxNumber": "815-401-7684",
    "FirstLinePracticeLocationAddress": "187 S INDIANA AVE STE 307",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "KANKAKEE",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60901-3645",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "815-408-1262",
    "PracticeLocationAddressFaxNumber": "815-401-7684",
    "EnumerationDate": "09/12/2024",
    "LastUpdateDate": "09/12/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "MCKENNEY",
    "AuthorizedOfficialFirstName": "TRACY",
    "AuthorizedOfficialMiddleName": "R",
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "LCPC",
    "AuthorizedOfficialTelephoneNumber": "815-408-1262",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "261QM0850X",
          "TaxonomyName": "Adult Mental Health Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QR0405X",
          "TaxonomyName": "Substance Use Disorder Rehabilitation Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "251S00000X",
          "TaxonomyName": "Community/Behavioral Health Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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