NPI Code Detail JSON Logo

1649550997 NPI number — HEALTHY MIND PSYCHOLOGICAL SERVICES

NPI Number: 1649550997
Health Care Provider/Practitioner: HEALTHY MIND PSYCHOLOGICAL SERVICES

Information about “1649550997” NPI (HEALTHY MIND PSYCHOLOGICAL SERVICES) exists in 1649550997 in HTML format HTML  |  1649550997 in plain Text format TXT  |  1649550997 in PDF (Portable Document Format) PDF  |  1649550997 in an XML format XML  formats.

NPI Number : 1649550997 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1649550997",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "HEALTHY MIND PSYCHOLOGICAL SERVICES",
    "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": "PO BOX 96",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MC CLELLANDTOWN",
    "MailingAddressStateName": "PA",
    "MailingAddressPostalCode": "15458-0096",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "412-582-6296",
    "MailingAddressFaxNumber": "855-737-2544",
    "FirstLinePracticeLocationAddress": "3201 BELMONT ST",
    "SecondLinePracticeLocationAddress": "SUITE 716",
    "PracticeLocationAddressCityName": "BELLAIRE",
    "PracticeLocationAddressStateName": "OH",
    "PracticeLocationAddressPostalCode": "43906-1584",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "740-325-1199",
    "PracticeLocationAddressFaxNumber": "855-737-2544",
    "EnumerationDate": "08/18/2011",
    "LastUpdateDate": "05/04/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "KOTARSKY",
    "AuthorizedOfficialFirstName": "DAVID",
    "AuthorizedOfficialMiddleName": "V",
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "PHD",
    "AuthorizedOfficialTelephoneNumber": "740-325-1199",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "103TB0200X",
          "TaxonomyName": "Cognitive & Behavioral Psychologist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "103TC1900X",
          "TaxonomyName": "Counseling Psychologist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "103TC2200X",
          "TaxonomyName": "Clinical Child & Adolescent Psychologist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "103TF0000X",
          "TaxonomyName": "Family Psychologist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "103TC0700X",
          "TaxonomyName": "Clinical Psychologist",
          "LicenseNumber": "6726",
          "LicenseNumberStateCode": "OH",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        }
      ]
    }
  }
}
                
            

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