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1538861786 NPI number — ROBIKA MODAK MYLROIE PHD, LPC, CCTP, NCC

NPI Number: 1538861786
Health Care Provider/Practitioner: ROBIKA MODAK MYLROIE PHD, LPC, CCTP, NCC

Information about “1538861786” NPI (ROBIKA MODAK MYLROIE PHD, LPC, CCTP, NCC) exists in 1538861786 in HTML format HTML  |  1538861786 in plain Text format TXT  |  1538861786 in PDF (Portable Document Format) PDF  |  1538861786 in an XML format XML  formats.

NPI Number : 1538861786 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1538861786",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MYLROIE",
    "FirstName": "ROBIKA",
    "MiddleName": "MODAK",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "PHD, LPC, CCTP, NCC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "103 SUNFLOWER RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MADISON",
    "MailingAddressStateName": "MS",
    "MailingAddressPostalCode": "39110-7878",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "662-694-0247",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1000 HIGHLAND COLONY PKWY STE 7203",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "RIDGELAND",
    "PracticeLocationAddressStateName": "MS",
    "PracticeLocationAddressPostalCode": "39157-2073",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "56-060-1715",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/21/2023",
    "LastUpdateDate": "03/21/2023",
    "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": "1636",
          "LicenseNumberStateCode": "MS",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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