{
"Npi": {
"NPI": "1619777240",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BOSS PSYCHIATRY & COUNSELING",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 423356",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KISSIMMEE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34742-3356",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "347-460-9989",
"MailingAddressFaxNumber": "407-337-0137",
"FirstLinePracticeLocationAddress": "PO BOX 423356",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "KISSIMMEE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34742-3356",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "772-828-8041",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/13/2025",
"LastUpdateDate": "02/09/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DERINOR",
"AuthorizedOfficialFirstName": "MARA-JOANNE",
"AuthorizedOfficialMiddleName": "S",
"AuthorizedOfficialTitle": "MANAGER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DNP",
"AuthorizedOfficialTelephoneNumber": "772-828-8041",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM0801X",
"TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}