{
"Npi": {
"NPI": "1568959898",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MCGINNIS",
"FirstName": "MATTHEW",
"MiddleName": "W",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "CSC-AD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2713 LANCASTER AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WILMINGTON",
"MailingAddressStateName": "DE",
"MailingAddressPostalCode": "19805-5220",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2713 LANCASTER AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WILMINGTON",
"PracticeLocationAddressStateName": "DE",
"PracticeLocationAddressPostalCode": "19805-5220",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "443-485-6544",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/23/2018",
"LastUpdateDate": "11/08/2022",
"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": "101YA0400X",
"TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
"LicenseNumber": "SC2498",
"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}