{
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"FirstLineMailingAddress": "5932 LEELAND ST S",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAINT PETERSBURG",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33715-1636",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "727-641-3819",
"MailingAddressFaxNumber": "727-864-3757",
"FirstLinePracticeLocationAddress": "111 2ND AVE NE",
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"EnumerationDate": "06/25/2012",
"LastUpdateDate": "06/25/2012",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GRIFFIN",
"AuthorizedOfficialFirstName": "ROXANNE",
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"AuthorizedOfficialCredential": "LMHC",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Mental Health Counselor",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}