{
"Npi": {
"NPI": "1578885810",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CRUSE",
"FirstName": "RUSSELL",
"MiddleName": null,
"NamePrefix": "MR.",
"NameSuffix": null,
"Credential": "LPCC-S",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "CRUSE",
"OtherFirstName": "RUSTY",
"OtherMiddleName": null,
"OtherNamePrefix": "MR.",
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "562 GARNER DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "COVINGTON",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "41015-2323",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "513-520-0252",
"MailingAddressFaxNumber": "513-586-0998",
"FirstLinePracticeLocationAddress": "9475 KENWOOD RD STE 13",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BLUE ASH",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "45242-6830",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "513-535-3653",
"PracticeLocationAddressFaxNumber": "513-586-0998",
"EnumerationDate": "02/26/2010",
"LastUpdateDate": "01/24/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "101YP2500X",
"TaxonomyName": "Professional Counselor",
"LicenseNumber": "E0007705",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}