{
"Npi": {
"NPI": "1538272711",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "RISSE",
"FirstName": "MARTIN",
"MiddleName": "A.",
"NamePrefix": "MR.",
"NameSuffix": "JR.",
"Credential": "L.P.C.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "101 E MAIN ST",
"SecondLineMailingAddress": "SUITE 2100",
"MailingAddressCityName": "FESTUS",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "63028-1904",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "636-933-4870",
"MailingAddressFaxNumber": "636-933-4875",
"FirstLinePracticeLocationAddress": "101 E MAIN ST",
"SecondLinePracticeLocationAddress": "SUITE 2100",
"PracticeLocationAddressCityName": "FESTUS",
"PracticeLocationAddressStateName": "MO",
"PracticeLocationAddressPostalCode": "63028-1904",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "636-933-4870",
"PracticeLocationAddressFaxNumber": "636-933-4875",
"EnumerationDate": "08/15/2006",
"LastUpdateDate": "07/08/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "101YP2500X",
"TaxonomyName": "Professional Counselor",
"LicenseNumber": "2005038598",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}