{
"Npi": {
"NPI": "1588006159",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "IRENE T SACK COUNSELING SERVICES",
"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": "300 TULIP ST",
"SecondLineMailingAddress": "ROOM 20",
"MailingAddressCityName": "LIVERPOOL",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "13088-4965",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "315-247-3208",
"MailingAddressFaxNumber": "315-453-6347",
"FirstLinePracticeLocationAddress": "300 TULIP ST",
"SecondLinePracticeLocationAddress": "ROOM 20",
"PracticeLocationAddressCityName": "LIVERPOOL",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "13088-4965",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "315-247-3208",
"PracticeLocationAddressFaxNumber": "315-453-6347",
"EnumerationDate": "07/24/2013",
"LastUpdateDate": "07/24/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SACK",
"AuthorizedOfficialFirstName": "IRENE",
"AuthorizedOfficialMiddleName": "T",
"AuthorizedOfficialTitle": "OWNER/ CLINICAL SOCIAL WORKER",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LCSW,CASAC,CHT",
"AuthorizedOfficialTelephoneNumber": "315-247-3208",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "305R00000X",
"TaxonomyName": "Preferred Provider Organization",
"LicenseNumber": "R052758-1",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}