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1508529165 NPI number — CHRISTY LYNNE LEDUC MA, MS, LAMFT

NPI Number: 1508529165
Health Care Provider/Practitioner: CHRISTY LYNNE LEDUC MA, MS, LAMFT

Information about “1508529165” NPI (CHRISTY LYNNE LEDUC MA, MS, LAMFT) exists in 1508529165 in HTML format HTML  |  1508529165 in plain Text format TXT  |  1508529165 in PDF (Portable Document Format) PDF  |  1508529165 in an XML format XML  formats.

NPI Number : 1508529165 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1508529165",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LEDUC",
    "FirstName": "CHRISTY",
    "MiddleName": "LYNNE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MA, MS, LAMFT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "LEDUC",
    "OtherFirstName": "CHRIS",
    "OtherMiddleName": "L",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MA, MS, LMFT",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "2747 PARK DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SAINT CLOUD",
    "MailingAddressStateName": "MN",
    "MailingAddressPostalCode": "56303-1346",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "320-248-8004",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "600 25TH AVE S STE 102",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAINT CLOUD",
    "PracticeLocationAddressStateName": "MN",
    "PracticeLocationAddressPostalCode": "56301-4820",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "320-406-1600",
    "PracticeLocationAddressFaxNumber": "320-406-1700",
    "EnumerationDate": "10/20/2021",
    "LastUpdateDate": "12/06/2024",
    "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": "106H00000X",
        "TaxonomyName": "Marriage & Family Therapist",
        "LicenseNumber": "4088",
        "LicenseNumberStateCode": "MN",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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