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1558808352 NPI number — LACIE MARIE BRUBAKER LPCC

NPI Number: 1558808352
Health Care Provider/Practitioner: LACIE MARIE BRUBAKER LPCC

Information about “1558808352” NPI (LACIE MARIE BRUBAKER LPCC) exists in 1558808352 in HTML format HTML  |  1558808352 in plain Text format TXT  |  1558808352 in PDF (Portable Document Format) PDF  |  1558808352 in an XML format XML  formats.

NPI Number : 1558808352 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1558808352",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BRUBAKER",
    "FirstName": "LACIE",
    "MiddleName": "MARIE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LPCC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "87 N CANTON RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "AKRON",
    "MailingAddressStateName": "OH",
    "MailingAddressPostalCode": "44305-3838",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "330-733-7993",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "87 N CANTON RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "AKRON",
    "PracticeLocationAddressStateName": "OH",
    "PracticeLocationAddressPostalCode": "44305",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "330-733-7993",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/31/2017",
    "LastUpdateDate": "10/09/2020",
    "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": "C.1800877",
          "LicenseNumberStateCode": "OH",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "E.2001936",
          "LicenseNumberStateCode": "OH",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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