{
"Npi": {
"NPI": "1619514338",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NEW LIFE COUNSELING & CONSULTING 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": "1310 3RD ST SW STE 2",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ROANOKE",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "24016-5219",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "540-384-0767",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3524 BRAMBLETON AVE STE 6",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ROANOKE",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "24018-6528",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "540-384-0767",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/01/2019",
"LastUpdateDate": "11/02/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "COWAN",
"AuthorizedOfficialFirstName": "SABRINA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "THERAPIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LPC",
"AuthorizedOfficialTelephoneNumber": "540-384-0767",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}