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1477908465 NPI number — ANGELA MARIE TAYSON MA, LPC

NPI Number: 1477908465
Health Care Provider/Practitioner: ANGELA MARIE TAYSON MA, LPC

Information about “1477908465” NPI (ANGELA MARIE TAYSON MA, LPC) exists in 1477908465 in HTML format HTML  |  1477908465 in plain Text format TXT  |  1477908465 in PDF (Portable Document Format) PDF  |  1477908465 in an XML format XML  formats.

NPI Number : 1477908465 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1477908465",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "TAYSON",
    "FirstName": "ANGELA",
    "MiddleName": "MARIE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MA, LPC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "VALLANCE",
    "OtherFirstName": "ANGELA",
    "OtherMiddleName": "MARIE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MA, PPC",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1056 ALPINE DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GREEN BAY",
    "MailingAddressStateName": "WI",
    "MailingAddressPostalCode": "54311-5400",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "231-420-6707",
    "MailingAddressFaxNumber": "--",
    "FirstLinePracticeLocationAddress": "1056 ALPINE DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GREEN BAY",
    "PracticeLocationAddressStateName": "WI",
    "PracticeLocationAddressPostalCode": "54311-5400",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "231-420-6707",
    "PracticeLocationAddressFaxNumber": "--",
    "EnumerationDate": "04/27/2016",
    "LastUpdateDate": "09/06/2024",
    "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": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "PPC-1114",
          "LicenseNumberStateCode": "WY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "LPC-2028",
          "LicenseNumberStateCode": "WY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "10336-125",
          "LicenseNumberStateCode": "WI",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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