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1578083556 NPI number — LORETTA SALOME OHMAYE LPCC

NPI Number: 1578083556
Health Care Provider/Practitioner: LORETTA SALOME OHMAYE LPCC

Information about “1578083556” NPI (LORETTA SALOME OHMAYE LPCC) exists in 1578083556 in HTML format HTML  |  1578083556 in plain Text format TXT  |  1578083556 in PDF (Portable Document Format) PDF  |  1578083556 in an XML format XML  formats.

NPI Number : 1578083556 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1578083556",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "OHMAYE",
    "FirstName": "LORETTA",
    "MiddleName": "SALOME",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LPCC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "OHMAYE",
    "OtherFirstName": "LARA",
    "OtherMiddleName": "SALOME",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "LPCC",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "4 BRIMHALL WASH",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SANTA FE",
    "MailingAddressStateName": "NM",
    "MailingAddressPostalCode": "87508-4817",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "505-930-0186",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2209 MIGUEL CHAVEZ RD",
    "SecondLinePracticeLocationAddress": "BLDG A, STE B",
    "PracticeLocationAddressCityName": "SANTA FE",
    "PracticeLocationAddressStateName": "NM",
    "PracticeLocationAddressPostalCode": "87505-6914",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "505-930-0186",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/21/2017",
    "LastUpdateDate": "03/02/2022",
    "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": "CCMH0192471",
        "LicenseNumberStateCode": "NM",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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