{
"Npi": {
"NPI": "1629471446",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "RIVERSIDE COUNSELING CENTER LLC",
"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": "205 BULLOCKS POINT AVE",
"SecondLineMailingAddress": "SUITE 205 B",
"MailingAddressCityName": "RIVERSIDE",
"MailingAddressStateName": "RI",
"MailingAddressPostalCode": "02915-5336",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "401-270-7379",
"MailingAddressFaxNumber": "401-270-1824",
"FirstLinePracticeLocationAddress": "205 BULLOCKS POINT AVE",
"SecondLinePracticeLocationAddress": "SUITE 205 B",
"PracticeLocationAddressCityName": "RIVERSIDE",
"PracticeLocationAddressStateName": "RI",
"PracticeLocationAddressPostalCode": "02915-5336",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "401-270-7379",
"PracticeLocationAddressFaxNumber": "401-270-1824",
"EnumerationDate": "10/07/2014",
"LastUpdateDate": "10/07/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "AREL",
"AuthorizedOfficialFirstName": "PATRICIA",
"AuthorizedOfficialMiddleName": "A",
"AuthorizedOfficialTitle": "CEO/OWNER",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LCMHC",
"AuthorizedOfficialTelephoneNumber": "401-270-7379",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "101YA0400X",
"TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
"LicenseNumber": "CDP00290",
"LicenseNumberStateCode": "RI",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "101YM0800X",
"TaxonomyName": "Mental Health Counselor",
"LicenseNumber": "MHC00181",
"LicenseNumberStateCode": "RI",
"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."
},
{
"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."
}
]
}
}
}