{
"Npi": {
"NPI": "1598805764",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LIFEWORKS THERAPY SOLUTIONS INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
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"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1101 HILLCREST DR",
"SecondLineMailingAddress": "PO BOX 308",
"MailingAddressCityName": "WOODWARD",
"MailingAddressStateName": "OK",
"MailingAddressPostalCode": "73801-3027",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "580-256-6100",
"MailingAddressFaxNumber": "580-256-6101",
"FirstLinePracticeLocationAddress": "1101 HILLCREST DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WOODWARD",
"PracticeLocationAddressStateName": "OK",
"PracticeLocationAddressPostalCode": "73801-3027",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "580-256-6100",
"PracticeLocationAddressFaxNumber": "580-256-6101",
"EnumerationDate": "02/07/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "REYNOLDS",
"AuthorizedOfficialFirstName": "STACY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "OTR",
"AuthorizedOfficialTelephoneNumber": "580-256-6100",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "174400000X",
"TaxonomyName": "Specialist",
"LicenseNumber": "OT459",
"LicenseNumberStateCode": "OK",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}