NPI Code Detail JSON Logo

1578789582 NPI number — CECILIA ANN RENAUD MA

NPI Number: 1578789582
Health Care Provider/Practitioner: CECILIA ANN RENAUD MA

Information about “1578789582” NPI (CECILIA ANN RENAUD MA) exists in 1578789582 in HTML format HTML  |  1578789582 in plain Text format TXT  |  1578789582 in PDF (Portable Document Format) PDF  |  1578789582 in an XML format XML  formats.

NPI Number : 1578789582 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1578789582",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "RENAUD",
    "FirstName": "CECILIA",
    "MiddleName": "ANN",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "MA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "RENAUD",
    "OtherFirstName": "CEIL",
    "OtherMiddleName": "ANN",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "MA",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "128 ENCHANTED PKWY",
    "SecondLineMailingAddress": "SUITE 210",
    "MailingAddressCityName": "MANCHESTER",
    "MailingAddressStateName": "MO",
    "MailingAddressPostalCode": "63021-5497",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "314-749-3300",
    "MailingAddressFaxNumber": "636-207-7316",
    "FirstLinePracticeLocationAddress": "128 ENCHANTED PKWY",
    "SecondLinePracticeLocationAddress": "SUITE 210",
    "PracticeLocationAddressCityName": "MANCHESTER",
    "PracticeLocationAddressStateName": "MO",
    "PracticeLocationAddressPostalCode": "63021-5497",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "314-749-3300",
    "PracticeLocationAddressFaxNumber": "636-207-7316",
    "EnumerationDate": "04/18/2007",
    "LastUpdateDate": "07/08/2007",
    "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": "101Y00000X",
        "TaxonomyName": "Counselor",
        "LicenseNumber": "CS002008",
        "LicenseNumberStateCode": "MO",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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