{
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"ReplacementNPI": null,
"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ANCHOR COUNSELING GROUP, A PROFESSIONAL CORPORATION FOR INDIV",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "24469 MIRA VISTA ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "VALENCIA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91355-6037",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "818-937-1095",
"MailingAddressFaxNumber": "818-962-6254",
"FirstLinePracticeLocationAddress": "138 N BRAND BLVD STE 303",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GLENDALE",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91203-4621",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "818-497-7470",
"PracticeLocationAddressFaxNumber": "818-660-1085",
"EnumerationDate": "05/11/2017",
"LastUpdateDate": "01/10/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SOLTANIAN",
"AuthorizedOfficialFirstName": "AVO",
"AuthorizedOfficialMiddleName": "AVEH",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LMFT",
"AuthorizedOfficialTelephoneNumber": "818-497-7470",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "MFC45151",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}