{
"Npi": {
"NPI": "1598623548",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BUTTERFLY WELLNESS 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": "139 S JUNCTION AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CAVE JUNCTION",
"MailingAddressStateName": "OR",
"MailingAddressPostalCode": "97523-9006",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "458-592-1622",
"MailingAddressFaxNumber": "855-535-0207",
"FirstLinePracticeLocationAddress": "535 E RIVER ST STE 106",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CAVE JUNCTION",
"PracticeLocationAddressStateName": "OR",
"PracticeLocationAddressPostalCode": "97523-9336",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "458-592-1622",
"PracticeLocationAddressFaxNumber": "855-535-0207",
"EnumerationDate": "01/09/2026",
"LastUpdateDate": "01/09/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VALLEJO",
"AuthorizedOfficialFirstName": "CAROL",
"AuthorizedOfficialMiddleName": "JANETTE",
"AuthorizedOfficialTitle": "OWNER/CLINICIAN",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MSW, LCSW",
"AuthorizedOfficialTelephoneNumber": "435-229-7805",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"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."
}
}
}
}