NPI Code Detail JSON Logo

1558514539 NPI number — MARY ANN B. JEPSEN LPCC

NPI Number: 1558514539
Health Care Provider/Practitioner: MARY ANN B. JEPSEN LPCC

Information about “1558514539” NPI (MARY ANN B. JEPSEN LPCC) exists in 1558514539 in HTML format HTML  |  1558514539 in plain Text format TXT  |  1558514539 in PDF (Portable Document Format) PDF  |  1558514539 in an XML format XML  formats.

NPI Number : 1558514539 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1558514539",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "JEPSEN",
    "FirstName": "MARY ANN",
    "MiddleName": "B.",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "LPCC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 1586",
    "SecondLineMailingAddress": "COVENANT INTEGRATIVE COUNSELING SERVICES",
    "MailingAddressCityName": "POWELL",
    "MailingAddressStateName": "OH",
    "MailingAddressPostalCode": "43065-1586",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "614-309-2270",
    "MailingAddressFaxNumber": "614-436-6884",
    "FirstLinePracticeLocationAddress": "9633 E STATE ROUTE 37",
    "SecondLinePracticeLocationAddress": "ST. JOHN NEUMANN CATHOLIC CATHOLIC CHURCH",
    "PracticeLocationAddressCityName": "SUNBURY",
    "PracticeLocationAddressStateName": "OH",
    "PracticeLocationAddressPostalCode": "43074-9672",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "614-309-2270",
    "PracticeLocationAddressFaxNumber": "614-436-6884",
    "EnumerationDate": "11/04/2008",
    "LastUpdateDate": "09/23/2013",
    "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": "101YP2500X",
        "TaxonomyName": "Professional Counselor",
        "LicenseNumber": "E 0700010",
        "LicenseNumberStateCode": "OH",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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