NPI Code Detail JSON Logo

1578216891 NPI number — JOANNA GILLIS LICENSED CLINICAL SOCIAL WORKER GILLIS THERAPY GROUP INC

NPI Number: 1578216891
Health Care Provider/Practitioner: JOANNA GILLIS LICENSED CLINICAL SOCIAL WORKER GILLIS THERAPY GROUP INC

Information about “1578216891” NPI (JOANNA GILLIS LICENSED CLINICAL SOCIAL WORKER GILLIS THERAPY GROUP INC) exists in 1578216891 in HTML format HTML  |  1578216891 in plain Text format TXT  |  1578216891 in PDF (Portable Document Format) PDF  |  1578216891 in an XML format XML  formats.

NPI Number : 1578216891 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1578216891",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "JOANNA GILLIS LICENSED CLINICAL SOCIAL WORKER GILLIS THERAPY GROUP INC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2080 CENTURY PARK E STE 1406",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CENTURY CITY",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "90067-2017",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "424-394-0295",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2080 CENTURY PARK E STE 1406",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CENTURY CITY",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "90067-2017",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "424-394-0295",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/27/2022",
    "LastUpdateDate": "02/15/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "FERNER",
    "AuthorizedOfficialFirstName": "MICHAEL",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OFFICE MANAGER",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "424-394-0312",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "106H00000X",
          "TaxonomyName": "Marriage & Family Therapist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        }
      ]
    }
  }
}
                
            

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