1518342781 NPI number — APRIL VANBERGEN M.A., NCC, LPC

NPI Number: 1518342781
Health Care Provider/Practitioner: APRIL VANBERGEN M.A., NCC, LPC

NPI Number : 1518342781 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1518342781",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "VANBERGEN",
    "FirstName": "APRIL",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "M.A., NCC, LPC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "VAN BERGEN",
    "OtherFirstName": "APRIL",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "LPC",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "1275 POST RD STE A19",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FAIRFIELD",
    "MailingAddressStateName": "CT",
    "MailingAddressPostalCode": "06824-6060",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "203-900-7060",
    "MailingAddressFaxNumber": "800-587-9152",
    "FirstLinePracticeLocationAddress": "1275 POST RD STE A19",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FAIRFIELD",
    "PracticeLocationAddressStateName": "CT",
    "PracticeLocationAddressPostalCode": "06824-6060",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "203-900-7060",
    "PracticeLocationAddressFaxNumber": "800-587-9152",
    "EnumerationDate": "07/29/2015",
    "LastUpdateDate": "01/19/2021",
    "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": "101YS0200X",
          "TaxonomyName": "School Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "003127",
          "LicenseNumberStateCode": "CT",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}