{
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"OrgName": "DUPAGE CLINICAL COUNSELING SERVICES",
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"FirstLineMailingAddress": "214 WINDSOR DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BOLINGBROOK",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60440",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "630-965-1359",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "450 E 22ND ST",
"SecondLinePracticeLocationAddress": "SUITE 150",
"PracticeLocationAddressCityName": "LOMBARD",
"PracticeLocationAddressStateName": "IL",
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"EnumerationDate": "06/23/2016",
"LastUpdateDate": "06/23/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GEHLE",
"AuthorizedOfficialFirstName": "CARLA",
"AuthorizedOfficialMiddleName": null,
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"AuthorizedOfficialNamePrefix": null,
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"AuthorizedOfficialCredential": "LCPC",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Professional Counselor",
"LicenseNumber": "180010152",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupName": "193400000X 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."
}
}
}
}