{
"Npi": {
"NPI": "1639502545",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BONNY PARKHURST, LPC, PLLC",
"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": "4524 S KINGSTON AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TULSA",
"MailingAddressStateName": "OK",
"MailingAddressPostalCode": "74135-6536",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "918-292-9432",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1201 E 33RD ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "TULSA",
"PracticeLocationAddressStateName": "OK",
"PracticeLocationAddressPostalCode": "74105-2017",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "918-292-9432",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/14/2013",
"LastUpdateDate": "08/14/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PARKHURST",
"AuthorizedOfficialFirstName": "BONNY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER / LICENSED COUNSELOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MS, LPC",
"AuthorizedOfficialTelephoneNumber": "918-202-9432",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "302F00000X",
"TaxonomyName": "Exclusive Provider Organization",
"LicenseNumber": "5006",
"LicenseNumberStateCode": "OK",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}