{
"Npi": {
"NPI": "1528105681",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HARVEST FREEWILL BAPTIST CHILD CARE MINISTRIES, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 259",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DUFFIELD",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "24244-0259",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "276-523-2315",
"MailingAddressFaxNumber": "276-523-7015",
"FirstLinePracticeLocationAddress": "RR 1 BOX 136",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DUFFIELD",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "24244-9622",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "276-523-2315",
"PracticeLocationAddressFaxNumber": "276-523-7015",
"EnumerationDate": "01/30/2007",
"LastUpdateDate": "09/11/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DOTSON",
"AuthorizedOfficialFirstName": "NEWL",
"AuthorizedOfficialMiddleName": "K.",
"AuthorizedOfficialTitle": "EXEUCTIVE DIRECTOR",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.A.",
"AuthorizedOfficialTelephoneNumber": "276-523-2315",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2084P0804X",
"TaxonomyName": "Child & Adolescent Psychiatry Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "103TC2200X",
"TaxonomyName": "Clinical Child & Adolescent Psychologist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": [
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
]
}
}
}