NPI Code Detail JSON Logo

1578602413 NPI number — ACTION COUNSELING SERVICE LLC

NPI Number: 1578602413
Health Care Provider/Practitioner: ACTION COUNSELING SERVICE LLC

Information about “1578602413” NPI (ACTION COUNSELING SERVICE LLC) exists in 1578602413 in HTML format HTML  |  1578602413 in plain Text format TXT  |  1578602413 in PDF (Portable Document Format) PDF  |  1578602413 in an XML format XML  formats.

NPI Number : 1578602413 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1578602413",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ACTION COUNSELING SERVICE LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 697",
    "SecondLineMailingAddress": "3507 RIVERSIDE DR",
    "MailingAddressCityName": "ROSWELL",
    "MailingAddressStateName": "NM",
    "MailingAddressPostalCode": "88202",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "505-317-5101",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3505 RIVERSIDE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ROSWELL",
    "PracticeLocationAddressStateName": "NM",
    "PracticeLocationAddressPostalCode": "88201",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "505-317-5101",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/06/2007",
    "LastUpdateDate": "09/11/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "JIMENEZ",
    "AuthorizedOfficialFirstName": "GILBERT",
    "AuthorizedOfficialMiddleName": "E",
    "AuthorizedOfficialTitle": "CLINICAL THERAPIST",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "PHD LMFT LPCC",
    "AuthorizedOfficialTelephoneNumber": "505-317-5101",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "LPCC005511",
          "LicenseNumberStateCode": "NM",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "106H00000X",
          "TaxonomyName": "Marriage & Family Therapist",
          "LicenseNumber": "LMFT4794",
          "LicenseNumberStateCode": "NM",
          "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."
        },
        {
          "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."
        }
      ]
    }
  }
}
                
            

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