{
"Npi": {
"NPI": "1629328067",
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "WISCONSIN LUTHERAN CHILD & FAMILY SERVICES",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
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"OtherMiddleName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "W175N11120 STONEWOOD DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GERMANTOWN",
"MailingAddressStateName": "WI",
"MailingAddressPostalCode": "53022-6511",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "262-345-5560",
"MailingAddressFaxNumber": "262-345-5531",
"FirstLinePracticeLocationAddress": "1660 HASLETT RD",
"SecondLinePracticeLocationAddress": "SUITE 1",
"PracticeLocationAddressCityName": "HASLETT",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "48840-8469",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "800-438-1772",
"PracticeLocationAddressFaxNumber": "262-345-5531",
"EnumerationDate": "09/13/2012",
"LastUpdateDate": "09/13/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RANGEL",
"AuthorizedOfficialFirstName": "LINDA",
"AuthorizedOfficialMiddleName": "MARIE",
"AuthorizedOfficialTitle": "INSURANCE COORDINATOR",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "262-345-5533",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "819-124",
"LicenseNumberStateCode": "MI",
"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."
}
}
}
}