{
"Npi": {
"NPI": "1518321041",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BLANCHARD",
"FirstName": "M. KATHLEEN",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "LPC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "KOPRIVA",
"OtherFirstName": "M. KATHLEEN",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "LPC",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "11042 MANCHESTER RD.",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KIRKWOOD",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "63122",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "314-223-3963",
"MailingAddressFaxNumber": "314-596-4559",
"FirstLinePracticeLocationAddress": "11042 MANCHESTER RD.",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "KIRKWOOD",
"PracticeLocationAddressStateName": "MO",
"PracticeLocationAddressPostalCode": "63122",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "314-223-3963",
"PracticeLocationAddressFaxNumber": "314-596-4559",
"EnumerationDate": "04/11/2016",
"LastUpdateDate": "05/24/2018",
"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": "20080117603",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "101YP2500X",
"TaxonomyName": "Professional Counselor",
"LicenseNumber": "2008017603",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}