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1538697073 NPI number — GRACE JOHANNA MONTES MA, LPC

NPI Number: 1538697073
Health Care Provider/Practitioner: GRACE JOHANNA MONTES MA, LPC

Information about “1538697073” NPI (GRACE JOHANNA MONTES MA, LPC) exists in 1538697073 in HTML format HTML  |  1538697073 in plain Text format TXT  |  1538697073 in PDF (Portable Document Format) PDF  |  1538697073 in an XML format XML  formats.

NPI Number : 1538697073 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1538697073",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MONTES",
    "FirstName": "GRACE",
    "MiddleName": "JOHANNA",
    "NamePrefix": "MISS",
    "NameSuffix": null,
    "Credential": "MA, LPC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MONTES VERGARA",
    "OtherFirstName": "GRACE",
    "OtherMiddleName": "JOHANNA",
    "OtherNamePrefix": "MISS",
    "OtherNameSuffix": null,
    "OtherCredential": "MA, LPC",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "154 CHILTON ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ELIZABETH",
    "MailingAddressStateName": "NJ",
    "MailingAddressPostalCode": "07202-1448",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "908-230-3999",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "220 LENOX AVE STE OFFICE5",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WESTFIELD",
    "PracticeLocationAddressStateName": "NJ",
    "PracticeLocationAddressPostalCode": "07090-5101",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "908-543-9100",
    "PracticeLocationAddressFaxNumber": "201-624-7846",
    "EnumerationDate": "05/29/2017",
    "LastUpdateDate": "04/03/2021",
    "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": "101Y00000X",
          "TaxonomyName": "Counselor",
          "LicenseNumber": "37PC00556100",
          "LicenseNumberStateCode": "NJ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "37PC00556100",
          "LicenseNumberStateCode": "NJ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "37PC00556100",
          "LicenseNumberStateCode": "NJ",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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