NPI Code Detail JSON Logo

1619209079 NPI number — SALLY GAY STROSAHL LCPC

NPI Number: 1619209079
Health Care Provider/Practitioner: SALLY GAY STROSAHL LCPC

Information about “1619209079” NPI (SALLY GAY STROSAHL LCPC) exists in 1619209079 in HTML format HTML  |  1619209079 in plain Text format TXT  |  1619209079 in PDF (Portable Document Format) PDF  |  1619209079 in an XML format XML  formats.

NPI Number : 1619209079 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1619209079",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "STROSAHL",
    "FirstName": "SALLY",
    "MiddleName": "GAY",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LCPC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "JOHNSON",
    "OtherFirstName": "SALLY",
    "OtherMiddleName": "STROSAHL",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "116 S WESTLAWN AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "AURORA",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60506-4622",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "630-554-1243",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "68 MAIN ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "OSWEGO",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60543-9861",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "630-554-1243",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/09/2010",
    "LastUpdateDate": "02/09/2010",
    "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": "101YP2500X",
        "TaxonomyName": "Professional Counselor",
        "LicenseNumber": "180.003012",
        "LicenseNumberStateCode": "IL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.